This case report describes five cases of acute granulomatous myringitis treated during the nine-year period from 1987 to 1996. Otorrhoea and slight otalgia were the two major complaints. Findings included the appearance of a granulomatous bulge along the handle of the malleus or on the eardrum. No cases displayed eardrum perforation. No similarities were noted in patient age, sex or affected side. Treatment consisted of removal of the granuloma with a small cup forceps plus cauterization with 20 per cent trichloracetic acid. Two or three treatments resulted in complete healing, and average time to healing was 30 days, with no recurrences. Because it differs so distinctly from the more common chronic myringitis--characterized by mild symptoms, erosion and perforation of the eardrum with little granulomatous change, and a longer time to healing with frequent recurrence--the authors conclude that acute granulomatous myringitis should be regarded as a separate entity.