Temporal bone injury is frequently associated with severe brain injury which limits the clinical evaluation and detracts from the clinical signs of temporal bone fracture such as sensorineural hearing loss, conductive hearing loss, and facial nerve paralysis. Radiologists are often the first to note the presence of temporal bone fractures and should be familiar with common types of injuries and their clinical implications. We review the traditional classification systems of temporal bone fractures with respect to clinical findings and management and suggest that radiologists should be familiar with the classification systems and, more importantly, focus their attention to identifying all critical temporal bone structures and describing their status of involvement to better the individual care.