Pneumocephalus is defined as the presence of air or gas within the cranial cavity. It is seen rarely in association with complications of otitis media. One of the well-known complications of otitis media is lateral sinus thrombosis (LST). Infection and inflammation in the mastoid and middle ear predispose for thrombosis in dural venous sinuses which is in close proximity to it. In the era of antibiotic treatment LST accounts for 6% of all intracranial complications. In this article we report a case of active chronic squamous type of otitis media with lateral sinus thrombosis with pnuemocephalus along with the review of literature.