CT is still the technique of choice to study the middle ear.  The value of MR in congenital middle ear malformations is restricted to the visualisation of congenital cholesteatomas, the detection and visualization of an abnormal course of arteries through the middle ear, the diagnosis of rare middle ear dermoids...  However, the impact of non-EPI DWI imaging in imaging of the "non-aerated" middle ear cannot be underestimated.  MR is able to distinguish fluid, fibrosis, cholesterol granuloma/protein rich collections and cholesteatoma from one another and CT is unable to provide this information.  The confirmation of the presence of a cholesteatoma, the visualization of its extend and the screening for recurrent or residual disease with non-EPI DWI imaging has made life easier for the ear surgeons and has led to an important reduction in healthcare costs (MR replaces second look surgery). Inflammatory disorders of the inner ear are numerous including labyrinthitis, apicitis, osteomyelitis, tuberculosis, Wegener's disease, congenital cholesteatomas etc.  Again MR, with the use of different sequences, is more sensitive and specific than CT.  It is also becoming clear that gadolinium enhancement is much better seen on FLAIR images than on T1 images.  The use of gadolinium is also crucial to detect the inflammatory disorders and also to detect the associated complications, especially towards the adjacent brain and veins. MR is the method of choice to study inner ear malformations.  Semicircular canal, vestibule and cochlear malformations can all be detected by MR and even the subtle congenital intracochlear "incomplete partition" changes, as described by L. Sennaroglu, can easily be depicted.  Moreover MR is also able to verify the presence of a normal cochleovesitibular nerve, crucial in patients with congenital sensorineural deafness needing a cochlear implant.The most frequent inflammatory and congenital disorders of the middle and inner ear will be illustrated and discussed in this presentation.