This essay is based on the analysis of clinical data coming from 20 cases of squamous carcinoma of the middle ear and review of lectures on squamous carcinoma of the middle ear. It shows that no clinical factor has been formed which would affect the prognosis of squamous carcinoma of the middle ear except the involved lymph node around the primary focus. Because the radical scalpel would destroy the local anatomic structure and it is difficult to drawn the tumor tissue perfectly. The author suggest that radiotherapy is the first choice of the simple squamous carcinoma of the middle ear. The surgical and radiation after surgery is not suitable preventive clearance and radiation is not necessary for the patient whose lymph node is negative.