Necrotizing otitis externa is an aggressive form of otitis externa. The infection spreads via the fissure of Santorini, particularly towards the bony cortex, and then leads to a true osteomyelitis of the base of the skull. It is a rare disease whose diagnosis is often difficult and the evolution can be serious.The positive diagnosis and management methods are still the subject of much controversy. Therapeutic management is mainly based on antibiotics and/or antifungals. Early and appropriate treatment as well as management of comorbidities can improve the prognosis