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:The parapharyngeal tumors are rare and treated mostly by surgical removal. The preoperative diagnosis of parapharyngeal tumors is very important because the surgical removal of neurogenic tumor, which is the main mass in the parapharyngeal space, can induce severe complications. There are many diagnostic tols for parapharyngeal tumors and their effectiveness are variable. In this study, we focused on the diagnostic accuracy of each diagnostic tool. Subjects and Method:Diagnostic tols used were computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), and fine needle aspiration biopsy (FNAB). Results:The diagnostic acuracy of MRI, CT and US was 68.2%, 51.6% and 42.8%, res-pectively. The sensitivity (83% ) and specificity (87.5%) of FNAB for neurogenic tumor are higher than those of MRI (75%, 50% ). Conclusion:These results suggest that FNAB is the most precise and reliable diagnostic tool and MRI is the most reasonable and effective imaging study. (Korean J Otolaryngol 2002;45:902-5)