Imaging of temporal bone is challenging due to the small size of the structures and intricate anatomy, as well as normal variants mimicking pathology. In the pre-operative setting, there are imaging nuances for detecting abnormalities that may influence surgical decision-making and guide the surgeon to the optimal treatment path. The post-operative imaging appearance of the temporal bone can be difficult to interpret due to the wide variety of surgical techniques and materials that may have been used. New imaging tools like photon counting CT have provided better ways to image this area. It is essential for the otoradiologist and the otologist to have a collaborative relationship and understanding of these nuances. This session will be taught by two leading otoradiologists at the forefront of temporal bone imaging, with emphasis on pre- and post-operative appearances of the temporal bone.