This review will focus on key recent advances in imaging of the temporal bone. The role of magnetic resonance imaging (MRI) in providing aetiological and prognostic information for patients with sudden sensorineural hearing loss will be discussed. Novel MRI sequences, such as delayed contrast-enhanced 3D fluid-attenuated inversion recovery (FLAIR) and their utility in the identification and grading of endolymphatic hydrops in Ménière's disease will be described. Furthermore, we will document the considerable advances in auditory implant technology (including active middle ear implants), and how multidetector computed tomography (CT) and cone-beam CT may be invaluable in their preoperative and postoperative assessment. Finally, advances in the imaging of cholesteatoma, third-window lesions, otospongiosis (including internal auditory canal diverticula), and vestibular schwannoma will be reviewed.