Salivary gland choristoma of the middle ear cavity is an extremely rare entity. Many patients with this entity usually present with conductive hearing loss. Many reports concentrate on the importance of conservative treatment of choristoma for fear of the possible injury of the facial nerve. We report another case of salivary choristoma of the middle ear in an 11-month-old girl. We performed a reconstruction surgery of the hearing mechanism, as well as tumor removal, and achieved satisfactory hearing results. If no remarkable facial nerve anomaly is detected in the preoperative evaluation, the reconstruction of the hearing mechanism with complete tumor removal might be considered.