Cholesterol granuloma is a cyst-like benign neoplasm containing cholesterol crystals usually surrounded by a fibrous capsule. Cholesterol crystals surrounded by giant multinucleated cells and lymphoid-histiocytic cellular infiltrates, which is a morphological manifestation of the body’s immune response. Therefore, cholesterol granuloma may be regarded as a favorable course of the inflammatory process, which previously could have a more active carious-granulation course. Most often, cholesterol granuloma affects the temporal bone and the middle ear cavity, the inner ear region, sella turcica of the sphenoid bone (Royer M. C., Pensak M. L.,2007). Clinical manifestations of cholesterol granuloma largely depend on its location. This pathology belongs to rare metabolic disorders with relatively few references to it in world literature. Currently, the diagnosis of apex petrosus cholesterol granulomas has been simplified by the new imaging techniques, such as Magnetic Resonance Imaging (MRI) and Computer Tomography (CT), which help us to save time for diagnostic and the percentage of errors in the diagnosis is reduced.