Objective To report a case of nasopharyngeal adenomatous lymphoma complicated with posterior nostril atresia, review the relevant literature, try to explore its possible source, and deepen the understanding of the diagnosis and treatment of the rare disease.Methods One patient with bilateral posterior nostril atresia was treated with transnasal endoscopic choanal plasty for repairing choanal atresia. During surgery, it was discovered that the the right posterior nostril was completely atresia and the left posterior nostril was narrowed. The left posterior nostril atresia was opened from the nasal septum by electric knife, removed it to the lateral side, expand posterior nostril. The same procedure was performed on the right side. The tissues were sent to the department of pathology for diagnosis.Results The bilateral posterior nostril was treated satisfactorily and the symptoms disappeared. Histological examination suggested for Warthin tumor. There was no recurrence during 1 year follow-up.Conclusion Warthin tumor of head and neck is mainly found in salivary gland, especially parotid gland. Warthin tumor is extremely rare in the nasopharynx. It is generally believed to originate from the small salivary glands scattered in the nasopharynx or mucosal metaplasia. Nasal endoscopic resection is a safe and effective treatment.