INTRODUCTIONDue to the complex anatomy of the temporal bone, conventional radiological methods like X-ray mastoid have limited ability to delineate the details of the temporal bone and cochlea-vestibular anatomy and disease pathology. The availability of modern highresolution computerized tomography (HRCT) scanners has resulted in ability to demonstrate the detailed temporal bone anatomy and identify significant structures and has revolutionalized the role of radiology in diagnosis and management of temporal bone diseases. 1 HRCT is particularly helpful in evaluating the anatomy and pathology of external auditory canal, middle ear cavity, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, vertical segment of facial nerve canal, sinodural angle, carotid canal, jugular fossa, infra and supralabrynthine air cells and temporomandibular joint; both soft tissue extension and significantly sensitive ABSTRACT Background: Conventional radiological methods like X-ray mastoid have limited ability to delineate the details of the complex temporal bone and cochlea-vestibular anatomy and disease pathology. This can be overcome by the use of High resolution computed tomography (HRCT) evaluation of the temporal bone. HRCT is helpful in evaluating the anatomy and pathology type and extent of disease, thereby helps in preoperative planning. Methods: The CT scan of forty five patients attending the outpatient department of otorhinolaryngology in a tertiary care centre between August 2014 to August 2017 was evaluated in this study. Each CT scan was interpreted by an otolaryngologist and a radiologist and interpretation was by consensus. The data collected was evaluated and results are reported as rates and proportions (%). Results:The study evaluated CT scan of 45 patients of which 35 were male patients and 10 were female patients with age ranging from 5 years to 75 years. Most of these patients belonged to the 21-30, 31-40 age groups [9 (20%) in each group]. Infections of middle ear cleft (all with cholesteatoma), fractures of the temporal bone, anomalies and tumors of the external auditory canal and middle ear were the pathologies observed in these CT scans with infection (otomastoiditis) [23 (51.1%)] being the most common pathology observed. Conclusions: Pre-operative CT scan may not only help in identifying the nature, extent of infectious disease including ossicular, bony erosions; it may also identify anomalies in the temporal bone and surrounding structures. Thus, HRCT temporal bone will help the surgeon in planning effective surgical strategy, reducing morbidity during the surgery.