Tympanosclerosis is a particular kind of chronic inflammatory response of the middle ear to mechanical injuries and/or infections. This condition is characterised by the formation of plaques presenting ultrastructural analogies with the atherosclerotic lesions, extended to the tympanic membrane and possibly to the ossicular chain. The less severe degree of tympanosclerosis is represented by asymptomatic and clinically unsignificant whitish plaques within the tympanic membrane, detectable at otoscopy. The pathogenesis of this phenomenon is supposed to present a tight relationship with the pathogenesis of atherosclerosis. This observation has been already reported in medical literature, but deserves further clinical confirmations to better define the real extent of the analogies of both affections. A practical implication of this matter of study could be the possibility to find out a fast and non-invasive test as an early marker of an increased risk of atherosclerotic disease: could otoscopy play such a role?