Objective To evaluate heat shock protein 90 (HSP90) expression in juvenile nasopharyngeal angiofibroma (JNA) and its association with tumor recurrence.Methods Immunohistochemistry was performed to assess HSP90 expression using tissue microarrays containing 60 JNA patients and 10 control subjects. The associations of HSP90 expression with clinicopathological features and tumor recurrence were analyzed through Pearson, Spearman, univariable and multivariable cox regression methods. Results Immunohistochemistry revealed high HSP90 expression in JNA compared with normal middle turbinate samples. High expression of HSP90, which correlated with MVD (R=0.379,P=0.001), ER-a (R=0.396,P=0.001), VEGF (R=0.612,P<0.001) and JNA recurrence (P=0.011), was an independent prognostic factor of time to recurrence (HR=3.251, 95%CI: 1.187-8.634, P=0.012). Conclusion HSP90 may be an independent prognostic marker in JNA patients administered surgical treatment.