Abstract Background We aimed to investigate the effect of radiological complete response on survival outcomes in patients with non-metastatic nasopharyngeal cancer. This study is conducted as a retrospective cohort. Of the 185 patients screened, 60 were metastatic, 25 patients’ data was not available, and as a result, 92 patients were included in the study. Among the complete response (CR) and incomplete response (IR) groups, overall survival (OS), distant metastasis-free survival (DMFS), and locoregional failure-free survival (LRFFS) were evaluated. Results Of the 92 patients, 54 (58.6%) were CR and 38 (41.4%) were IR patients. Of the whole study group, the 5-year OS, DMFS, and LRFFS rates were 75%, 78%, and 95%, respectively. A significant difference was found between the 5-year OS (90% vs. 60%, p = 0.001) and DMFS (87% vs. 65%, p = 0.02) rates. However, there was no significant difference in the 5-year LRFFS rate (97% vs. 92%, p = 0.16). Complete response were determined as an independent predictor for OS (HR: 0.13, 95% Cl: 0.045–0.36, p