Background <p>The external auditory canal cholesteatoma is a rare presentation as compared to squamosal otitis media. The overlapping presentation creates challenges in diagnosis and treatment of this condition. In this case series, we aim to provide a succinct overview delving into its etiology, clinical presentation, novel radiological diagnostic feature, and management strategies.</p> Case presentation <p>The case presentation unfolds with two instances of external auditory canal cholesteatoma in individuals aged 20 and 29, both presenting with otalgia and otorrhea. Clinical and oto-endoscopic evaluations, coupled with audiograms and radiographic studies presented.&#xa0;The high-resolution computed tomography features of the temporal bones of reduction in the thickness of tympanic bone are helpful for assessing disease severity and extent and may be used as the definite diagnostic tool.</p> Conclusion <p>Specific radiological changes of reduced thickness of tympanic bone described here are key to diagnosis. This presentation emphasizes the novel radiological feature in the diagnosis of external auditory canal cholesteatoma.</p>