After discovery of chemotherapeutics (1935) and antibiotics (1972), there has been markedly decreased in frequency of intracranial complications resulting from otitis media. But recently the incidence of intracranial complications has been increased because of misuse and abuse of antibiotics. Intracranial complications of chronic purulent otitis media are meningitis, brain abscess, epidural and subdural abscess, lateral sinus thrombosis, rarely epidural cholesteatoma and hydrocephalus. Recently author observed a 23 year old male patient suffering from otorrhea, hearing loss, facial paralysis on right side with neck stiffness, headache and mental irritability. He was clinically diagnosed of otogenic meningitis, but confirmed to epidural cholesteatoma after carotid angiography and operation through the middle cranial fossa approach. So author reports a rare case of epidural chelesteatoma resulting from chronic otitis media, with review of references.