The salivary gland choristoma is a congenital heterophic rest which has been reported in the middle ear. The mechanism by which salivary gland tissue arises in the middle ear is unknown. Although this disease is rare, the otologist should be aware of middle ear choristoma with its frequent association of ossicular and facial abnormalies. When the tumor is attached by a fine stalk, resection can be readily performed. In contrast, removal of a broadly based tumor overlying the fallopian canal may result in facial nerve injury. As malignant tumor formation has yet to be reported when a biopsy has revealed normal salivary gland tissue, complete resection of the tumor is not recommended if the facial nerve may be jeopardized. A case report of a salivary gland choristoma of the middle ear is presented and the literature is reviewed.