""Cholesterol granuloma"" is a disease consisting of granulation tissue in which large numbers of cholesterol crystals are irritant and provoke the formation of foreign-body giant cells and the development of fibrosis. Three factors play a significant role in the causation of cholesterol granuloma ; 1) disturbed ventilation, 2) impaired drainage, 3) hemorrhage. They are frequent phenomena accompanying chronic middle-ear disease but only a few cases were published in the paranasal sinus lesion. Among them cases with expansive growth were rare. The authors have recently experienced a case of cholesterol granuloma developed from the sphenoid sinus which extended to right superior orbital fissure and to pre-pontine cistern with clivus destruction in 50 years old female complaining diplopia and temporal headache.