The temporal bone is used frequently to determine taxonomic affinities as it contains several features that differentiate Neandertals from anatomically modern Homo sapiens. However, only little information is available about temporal bone pneumatization in Neandertals. This study provides descriptions and comparisons of the disposition and the extensiveness of the pneumatization of the temporal bone in large samples of Neandertal specimens of different geological and developmental ages (25 individuals and 33 temporal bones from the sites of Engis, Krapina, La Chapelle aux Saints, La Ferrassie, La Quina, Pech de l'Azé, and Spy). Although temporal bone pneumatization shows some individual variability, a similar pattern of distribution is found in all adult Neandertal individuals from Krapina and Western Europe. Pneumatization is restricted mainly to most parts of the petromastoid areas. We also retrace for the first time the modalities of growth and development of this pneumatization in Neandertals. Finally, this study provides new information about possible correlations between the extension and position of temporal bone pneumatization and some of the morphological features used to characterize the temporal bone of the Neandertals. These latter features include the relatively low and short temporal squama, the robust zygomatic process with a relatively marked lateral projection, the strong supramastoid crest, the significant thickness of the tympanic part of the temporal bone, and the relatively small mastoid process and large juxtamastoid eminence. Our results suggest that the development of pneumatization in Neandertals is related to available space and to temporal bone morphology. Moreover, it appears that the development of pneumatization does not play an active role in determining the morphology of the apomorphic features of the temporal bone in Neandertals.