The temporal bone is one of the most complex bones in the human body. Fractures require significant force and are usually associated with extensive damage to adjacent structures.Which imaging modality facilitates the assessment of petrous bone fractures, and which anatomical landmarks may be used for orientation?A literature search on PubMed.gov was conducted to determine the current state of research.Injuries to the petrous part of the temporal bone often involve the facial nerve and the vestibulocochlear nerve, as well as the cochlea and the vestibular organ. This article presents strategies to facilitate correct diagnosis.In addition to the (often knotty) description of the fracture, it is essential to assess the cranial nerves that transverse the petrous bone and to evaluate the auditory ossicles.