Chronic suppurative otitis media (CSOM) is one of the leading causes of hearing impairment in developing countries. Objectives: are to highlight the high resolution computerized tomography (HRCT) temporal bone findings in chronic middle ear infections with reference to it ' s extent and complications, as well, the presented common signs, symptoms and the duration impact on the anatomical structures and pathological changes in each part and for both sides. Materials and Methods: Preliminary clinical assessment was obtained for 114 patients diagnosed with CSOM, and then they were referred for a HRCT of temporal bone which was done using multi-detector CT scanner. Results: Of the 114 patients; 63(55.3%) were males and 51(44.7%) were females: Otorrhoea is the most common symptom, and was found in 113 patients constituting (99.1%) followed by Otolegia 69(60.5%) and headache affected 53(46.5%) of the cases. CSOM is more common in low socio-economic status .In ears affected with CSOM, the maximum CT number (Hounsfield) was found to be changed and was significantly affected with increasing patients' age. Sclerotic changes and soft tissue density increased as the duration of CSOM increased in right and left middle ears significantly (F=5.802, Sig at 0.000), and (F=23.182, Sig at .015) respectively. Partial and complete erosion were detected in both right and left ossicle in the advanced phase of disease, where the ossicle still intact in the early stage , and the correlation is found to be significant with increasing of CSOM duration (F=16.959, Sig 0.000) and (F= 3.673, Sig =0.036)for right and left ossicles respectively. Changes including total and partial opacification, sclerotic changes, soft tissue density, mucosal thickening were the findings detected in both right and left mastoid in HRCT for temporal bone scanning. Conclusions: HRCT of temporal bone is useful in identifying various findings related to the location and extent of disease.