Paresthesia is defined as a morbid, perverted, abnormal sensation such as burning, prickling or formication. Lip paresthesia can be either acute or chronic depending on the underlying condition. In cases of unilateral lip paresthesia, cranial nerves may be affected by regional causes. We present here a case of a 58-year-old Chinese gentleman complaining of left upper lip numbness. The numbness is concurrent to the left infraorbital and frontal area followed by pain. Nasoendoscopy by the Otorhinolaryngology team found abnormal growth in both left and right Fossa of Rosenmüller. Biopsies taken confirmed that they were non-keratinizing squamous cell carcinoma. A final diagnosis of nasopharyngeal tumour (NPC) (T4N2M0) was made. This case illustrates upper lip paresthesia as a possible presentation of NPC. A prompt referral to the appropriate speciality is needed by dental clinicians for further management in cases such as this.