Skull base osteomyelitis(SBO) has classically been considered as a complication of inadequately treated malignant external otitis. It has also been described in patients with chronic infection of the middle ear, mastoid and paranasal sinuses. SBO is mostly encountered in elderly patients with diabetes, and pseudomonas aeruginosa is the most frequent pathogen. The characteristic symptom is a unilateral deep-seated headache, followed by paralysis of lower cranial nerves. The findings of bacteriologic study, bone scan. Gallium scan, CT and MRI were important for diagnosis. Gallium scan is especially useful for monitoring the state of the disease and the response to treatment. The cure rate increased with advaned antibiotic therapy. A combination of aminoglycoside and semisynthetic penicillin or third-generation cephalosporin has been used. Oral ciprofloxacin has a simillar effect. The duration of treatment is determined by clearance on the Gallium scan and clinical response.