Nakayama beat Charlie Kohler (USA) in KOTC 43 on November 14, 2004, and became the King of the Cage Lightweight Champion.
He then lost his title to Mac Danzig on Oct 29th, 2005 in Reno, Nevada when his corner threw in the towel after he received over 20 unanswered strikes.
In April 2011, Nakayama cut down to the Featherweight division, and won by rear-naked choke submission against Yusuke Kawanago in Pancrase.
He became the Pancrase Interim Featherweight Champion by unanimous decision, defeating Tomonari Kanomata on September 4, 2011.
On June 2, 2012, Nakayama fight the Pancrase Interim Featherweight Championship, challenger Jon Shores, who was on a 10-fight winning streak.