Cholesteatoma is a mass formed by the keratinizing squamous epithelium in the tympanic cavity and/or mastoid that can lead to the destruction of surrounding structures in the ear. It can arise at any age. Symptoms are non-specific and diagnosis may be difficult on otoscopic examination. The management of cholesteatoma is surgical; mastoid obliteration has reduced the incidence of recurrent cholesteatoma in recent years. The use of diffusion-weighted MRI has proven to be a reliable technique for the detection and follow-up of cholesteatoma.