OBJECTIVE: To report a case of pyoderma gangrenosum due to titanium prosthesis used in stapedotomy. CASE REPORT: JSH Caucasian, 46 years old, with otosclerosis in both ears, underwent bilateral stapedotomy (October of 2006 to June of 2007 left and right ears respectively) with insertion of titanium prosthesis (Kurz), developed with excellent results bilaterally hearing. One year after the second procedure, she began to show an ulcerated skin lesion on the Pinna and left temporal region, diagnosed as pyoderma gangrenosum. Several medical treatments have been made without success. Some dermatologists advised removal of the prosthesis of the left ear. In the same period were performed audiometry, otoscopy and Computerized Tomography, all with normal results. After a few months the patient returned, complaining of tinnitus in the left ear. Audiometry was performed, which revealed severe sensorineural loss OE. Another Computerized Tomography unchanged. It was consensus among otologists, patient and family the option to remove the prosthesis. Tympanometry, middle ear was normal. The prosthesis was vibrating normally, and after being removed was not observed drainage of the vestibule. A month after the procedure patients return to service with excellent results healing of the lesion. CONCLUSION: The healing of pyoderma gangrenosum lesion after removal of the titanium prosthesis is highly suggestive of its participation in the genesis of this disease, which had not yet been reported in the literature in stapedotomy surgery.