Ossifying fibroma of the head and neck is most commonly described in the mandible and maxilla. A few isolated reports in the literature exhibit the rare existence of this lesion in the nasal bones, orbit, ethmoid sinus, sphenoid sinus, occiput, and in only two well-documented cases, the temporal bone. We present the case of an extensive ossifying fibroma of the temporal bone that presented as a suspected case of hyperostosis of the external auditory canal and conductive hearing loss, without any cosmetic deformity. A review of the recent literature concerning the sites, radiologic presentation, difficulty of pathologic differentiation, and modality of therapy is discussed.