Although most cholesterol granuloma may exist as a silent form of otitis media without clinical manifestations, we have experienced three cases of cholesterol granuloma patients who complained of hearing impairment or otorrhea. All cases were represented as intratympanic mass pressuring the tympanic membrane, causing it to bulge and were confirmed by surgical pathologic study. Cholesterol granulomas may appear as non-specific, soft tissue mass with variable bone erosion in CT scan and high signal intensity lesion in T₁ and T₂ weighted MR image. Both CT and MRI may help to diagnose and make a surgical plan for the cholesterol granuloma represented as an intratympanic mass.