Abstract: Objective To study the pathogenesis,clinical manifestations,diagnosis and treatment of cholesteatoma otitis media accompanying cholesterol granuloma and their relations. Methods Clinical data about 12 patients(12 ears) with cholesteatoma otitis media accompanying cholesterol granuloma diagnosed by surgery and pathology were retrospectively analyzed,including their clinical manifestations,CT scan of temporal bone,operation and follow-up. Results Of the 12 patients with recurrent otorpyorrhea,4 had jam-like secretion,3 had sanguine secretion,1 had bloody secretion,and 4 had purulent secretion.Hearing disability was manifested as mild-severe conductive hearing loss or mixed deafness.Mastoid CT scanning showed destruction of bone and bone resorption,which underwent mastoidectomy or modified radical mastoidectomy plus hearing reconstruction.The patients were followed up for 1-2 years,during which no recurrence was observed. Conclusion Jam-like or bloody otopyorrhea is one of the key characteristics of cholesteatoma otitis media accompanying cholesterol granuloma and surgery is the chief choice of its treatment.Hearing is reconstructed depending on the condition of patients.