Osteomyelitis of the temporomandibular joint is very uncommon, and osteomyelitis as a result of Aspergillus niger infection has not previously been reported. A case report of skull base and condylar osteomyelitis is presented. Previously reported cases of temporomandibular joint osteomyelitis are reviewed, and management is discussed. Because of the significant morbidity possible with infections in this region, otolaryngologists should be familiar with the anatomy, diagnostic modalities, and therapeutic options. [Editorial comment: This unusual case presents unique aspects of the pathophysiology of osteomyelitis of the skull base.]