Osteomyelitis of the temporal bone is a rare disease. The diagnosis and treatment of atypical osteomyelitis of the temporal bone in a 54-year-old woman was reported. The left temporal bone swelling grew slowly from age 9 with only slight deep-seated pain in the temporal area. This condition was assumed to be due to fibrous dysplasia or some benign tumor. It is supposed that exploratory and inadequate mastoidectomies performed on patients age 16 to 19 years might trigger temporal bone osteomyelitis. Extensive surgical debridement followed by antibiotic therapy for 4 weeks yielded good results, and now 2 years after treatment, no signs of recurrence have been observed. The utility of the gallium scan was confirmed for evaluation of disease activity.