Aim: Accurate diagnosis of skull base ear, nose, and throat (ENT) pathologies holds paramount importance in guiding effective treatment strategies and ensuring optimal patient outcomes. This review aims to elucidate the pivotal role of various imaging modalities in achieving precise diagnosis of skull base ENT pathologies. Background: The background section highlights the intricate anatomy and diverse range of pathologies affecting the skull base region. It emphasizes the challenges associated with clinical assessment alone and underscores the necessity for advanced imaging techniques. Methods: An extensive literature search was conducted to gather relevant studies on the application of imaging modalities for diagnosing skull base ENT pathologies. Various imaging techniques including computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and functional imaging modalities were investigated. Their distinct advantages, limitations, and specific use-cases in diagnosing different pathologies were analyzed. Results: The review presents the comprehensive role of imaging modalities in diagnosing skull base ENT pathologies. CT is instrumental in assessing bony structures, detecting fractures, and evaluating ossicular chain involvement. MRI provides superior soft tissue visualization, aiding in the diagnosis of tumors, vascular anomalies, and neural pathologies. PET imaging assists in identifying metabolic activity and differentiating benign from malignant lesions. Functional imaging techniques offer insights into physiological processes and neural pathways, contributing to refined diagnostics. Conclusion: Imaging modalities play a pivotal role in achieving accurate diagnosis of skull base ENT pathologies. The combination of CT, MRI, PET, and functional imaging techniques provides a holistic understanding of the pathology's extent, characteristics, and associated functional implications. Integrating these modalities with clinical findings enhances diagnostic accuracy, enabling tailored treatment approaches and improved patient care.