Introduction: Multiple myeloma is rarely associated to otologic alterations and can be mistaken for otitis. High resolution computer tomography can help in establishing the differential diagnosis of this disease, showing lesions of the temporal bone with inflammatory or neoplastic characteristics. Objective: To present a 47-year-old male patient who suffered from multiple myeloma with otologic alterations. Results: The authors report a case of patient with a long history of multiple myeloma and recent complaint of hearing loss and inflammation of the ear. The initial diagnosis was malignant external otitis, but the CT scan showed an expansible lytic lesion involving the temporal bone and soft tissues of the ear, suggesting the presence of multiple myeloma. Conclusions: The radiologic alterations of myeloma in CT scan of the temporal bone, although not specific, may increase the diagnostic possibilities of this disease.