PURPOSE: This cross-sectional study aimed to investigate the incidence and related factors of financial toxicity among nasopharyngeal carcinoma (NPC) patients and propose strategies for improvement. METHODS: Patients with nasopharyngeal carcinoma were recruited from December 2022 to June 2023 in Changsha, Hunan Province, China, using convenience sampling. A questionnaire survey focusing on financial toxicity among patients with nasopharyngeal carcinoma was conducted. The assessment tools used in this study include Comprehensive Scores for Financial Toxicity Based on the Patient-Reported Outcome Measures (COST-PROM), Medical Coping Modes Questionnaire (MCMQ), and Perceived Social Support Scale (PSSS). RESULTS: A total of 155 patients with nasopharyngeal carcinoma were included in the study. The incidence of financial toxicity among participants was found to be 65.8%, with an average COST score of 22.45 ± 7.91. A significant negative correlation was shown between MCMQ scores and financial toxicity in patients (r = -0.235, p = 0.003), while a significant positive correlation was demonstrated between the PSSS scores and financial toxicity (r = 0274, p = 0.001). The multiple linear regression analysis showed that personal monthly income, MCMQ scores, and PSSS scores were related to financial toxicity in patients with nasopharyngeal carcinoma. CONCLUSION: This study revealed a high prevalence of financial toxicity in patients with nasopharyngeal carcinoma. The medical staff needs to identify the financial toxicity early and adopt appropriate strategies to help patients with nasopharyngeal carcinoma return to work, guide them to choose positive medical coping modes, and access more excellent social support.