Giant cell lesions are rare in the temporal bone. A review of world literature reveals twenty-three reported cases. Histopathologic differentiation has been difficult in the past; several tumors of bone which are characterized by multinucleated giant cells have been grouped together under the term "giant cell tumor." In the temporal bone, true giant cell tumor of bone, osteoclastoma, should be differentiated from the less aggressive reparative granuloma. The clinical course of these two lesions can be greatly different. Two additional cases of giant cell reparative granuloma are added to the literature. In addition, a tabulation is presented of signs, symptoms, treatment, and follow-up in the cases reported in the literature. Surgical excision is recommended when possible.