A 47-year-old female patient presented with an acute onset of facial palsy and otitis media on the left side. Temporal bone CT scans revealed an irregularly shaped lesion in the middle ear cavity extending into the mastoid air cells. MRI images confirmed intra- and extra-temporal involvement of the facial nerve schwannoma. The correlation of distinct imaging findings of the facial nerve schwannoma along the course of the facial nerve and anatomical features of the temporal bone is discussed.