Temporal bone fractures are classified as longitudinal or transverse fractures, each with its own set of clinical characteristics. Transverse fractures mostly result in conductive hearing loss, but longitudinal fractures virtually always result in abrupt deafness, typically accompanied by vertigo. Longitudinal fractures are the most common cause of facial nerve paralysis. Imaging is considered essential in temporal bone fractures. To diagnose fractures, both temporal bones must be compared, as well as knowledge of normal temporal bone architecture, sutures, and fissures. It should be noted that delayed imaging is frequently necessary in the case of transverse fractures, since the concomitant middle ear and mastoid blood deposition may hide ossicular separation in the beginning, both clinically and on imaging. Because of its lower radiation doses and superior resolution, cone beam CT is favoured over CT for the examination of temporal bone fractures.