An unusual case of cholesterol granuloma of the temporal bone is described presenting as a cerebellopontine tumor. This lesion seemed to arise from an inflammatory process obstructing pneumatized cells. It consists of extradural granulation tissue and must be distinguished from intradural epidermoid cyst, which is, instead, a dysembryogenetic neoplasm. Simple drainage of the granuloma was accomplished by posterior fossa approach, but the lesion recurred after a year. The diagnosis and surgical management of cholesterol granuloma are discussed.