OBJECTIVE To study the overexpression of vascular endothelial growth factor (VEGF) and fluorine-18 fluorodeoxyglucose (FDG) uptake in early-stage nasopharyngeal carcinoma (NPC) and evaluate their relationship. METHODS FDG positron emission tomography (PET) was performed in forty patients with stage I and stage II NPC. The maximum and mean standard uptake values (SUVmax and SUVmean, respectively) were measured in each patient, and the expression of VEGF was measured on paraffin sections using immunohistochemistry. RESULTS The FDG uptake in the patients were 9.45-/+1.87 (SUVmax) and 6.04-/+1.09 (SUVmean), 8.95-/+1.91 (SUVmax) and 6.04-/+1.09 (SUVmean) in stage I patients, and 11.55-/+1.70 (SUVmax) and 7.98-/+1.1 (SUVmean) in stage II patients. The FDG uptake of stage II patients was higher than that of stage I patients. The FDG uptake of non-keratinizing differentiated carcinoma was 9.74-/+1.82 (SUVmax) and 6.82-/+1.23 (SUVmean) and 10.44-/+2.16 (SUVmax) and 6.68-/+1.35 (SUVmean) in non-keratinizing undifferentiated carcinoma, showing no significant differences between them (SUVmax: t=1.230, P>0.05; SUVmean: t=0.346, P>0.05). The VEGF-positive cells were 60.80% in the tumor. A correlation between VEGF expression and FDG uptake in he tumor was noted (r=0.460, P=0.03). CONCLUSION VEGF overexpression is correlated to FDG uptake in patients with early-stage NPC. The SUV value reflects the glucose metabolism of NPC, and also shows the degree of oxygen insufficiency in the tumor tissue.