Survival is related to the pathologic extent of tumor in external auditory meatus (EAM) carcinoma. This study assesses the validity of preoperative CT scans in staging EAM carcinoma. The accuracy of staging EAM carcinoma with preoperative CT scans was evaluated by comparing radiography and histopathology. Patients who received preoperative CT scan were selected from a retrospective series of 35 temporal bone resections for EAM squamous cell carcinoma. The CT scans were systematically reviewed for tumor involvement in 12 anatomic areas. The histopathology slides for the corresponding patients were reviewed according to the same criteria. CT scan findings accurately diagnosed the extent of tumor involvement identified during histopathologic examination. These tumors demonstrated the capacity to spread along existing anatomic pathways as well as direct bone erosion. We conclude that preoperative CT scans accurately stage EAM squamous cell carcinoma.