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The case presented includes a left temporal bone from an individual exhumed from the Hispano‐Mudejar necropolis in Uceda (Guadalajara, Spain) dated between the 13th and 14th centuries bc. External examination and computed tomography images show lesions in the external acoustic canal, in the form of diffuse widening, suggestive of a cholesteatoma originating in this canal, with invasion of the middle ear through the tympanic membrane. The difficulties with examining the internal elements of the ear are discussed, which causes the underestimation of these diseases in paleopathology studies. [ABSTRACT FROM AUTHOR]