The case of an osteoid osteoma of the middle ear in a 42 year old man is reported. No former case has now been reported in the literature for this localization. The suspected diagnosis of osteoid osteoma was based on the pain and the findings of bone computerize tomography. In our case, the osteoid osteoma was totally painless and the diagnosis was made after surgical findings by histological studies. Some clinical and imaging points, pathologic findings and differential diagnosis are also discussed.