External ear canal cholesteatoma (EECC) is rare in ear, nose and throat (ENT) practice. Two cases, one bilateral, are described. Computed tomography demonstrates the extent of bony involvement. Erosion of the external canal should not be overlooked when reviewing CT of the petrous bone in cases of discharge from the ear. EECC may necessitate surgery and delay in the diagnosis of EECC can result in progressive bony destruction.