OBJECTIVE - to tell the case of a patient who presented Syndrome of Gradenigo, being submitted the clinical treatment conservative, getting good evolution. CASE REPORT - patient masculine, 7 years, with right othorrea, face pain in twinges and diplopic with evolution of 1 week. To the examination was presented feverish, general good condition. Otoscopy disclosed to purulent secretion in auditory conduit external right and paralysis of the straight lateral ipsilateral muscle. Remain of the normal examination. Computerized Tomography of mastoid disclosed material with density of soft parts in average ear, cavern and mastoid cells with dehiscence of the cortical osseous of the petrous apex for posterior cranial pit. Magnetic resonance disclosed compatible image with collection in petrous apex forming a small abscess. Initiate intravenous antibioticotherapy with Ceftriaxone and Clindamicine, associate hydrocortisone. As the patient evolved well in first the 48 hours of the institution of the intravenous medication, was opted to keeping the treatment conservative. It no longer had ceasing of the othorrea and face pain in the third day of internment and return of ocular mobility to normal the sixth day. Magnetic resonance of control showed blot of the compatible apex with edema, without abscess signal. Patient received high in the twentieth day of internment. CONCLUSION - in the case of the patient in question, the treatment conservative showed a good option, since had good evolution in first the 48 hours of intravenous treatment, not needing surgical intervention, exactly having formation of abscess in the petrous apex.