Necrotising external otitis, also known as malignant otitis externa, is an aggressive, resorptive osteomyelitis of the temporal bone. Although rare, necrotising external otitis is a potentially fatal disease, with complications which include temporomandibular joint osteomyelitis, sigmoid sinus thrombosis and meningitis. Imaging findings may be subtle, particularly in the early stages. We present a broad range of imaging findings which may occur in necrotising external otitis cases.