<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is common disease prevalent in India. Patients coming to OPD who were clinically diagnosed as chronic otitis media (COM) were evaluated using High resolution computerised tomography (HRCT) temporal bone. HRCT temporal bone is highly useful in knowing the disease involving middle ear cleft and adjacent structures. Previous studies have indicated the importance of HRCT temporal bone in mapping anatomy and middle ear disease status in COM patients. The aim of the study was to assess radiological findings of chronic otitis media in both types, and to choose management plan based on the involvement of structures.</p><p class="abstract"><strong>Methods:</strong> A prospective study was done in 100 COM patients with both mucosal and squamosal disease, using HRCT temporal bone scan and features analyzed.  </p><p class="abstract"><strong>Results:</strong> Among 100 COM patients, 75 had mucosal disease, 25 had squamosal disease. In our study the most common age group was between 16 to 25 years (26%) and 46 to 55 years (24%).  The male: female ratio was 2:3.  In 100 clinically diagnosed COM participants, 10% of them were found to be radiologically negative. In 90% radiologically positive participants, findings showed radiolucent shadow in the mastoid and  middle ear cavity(67%), ossicular involvement(35%) and adjacent structures like epitympanum (22%), hypotympanum (2%), tegmen tympani (3%), Prussak’s space (20%), scutum involvement (18%), sinus tympani (3%), were noted by HRCT.</p><p class="abstract"><strong>Conclusions:</strong> HRCT temporal bone is a highly reliable diagnostic tool used for preoperative assessment of all COM patients planned for surgery.</p>