In the imaging assessment of malignant otitis externa (MOE), a systematic approach is essential for ensuring accurate diagnosis and identifying potential complications. The step-by-step evaluation of temporal CT scans and MRIs allows radiologists to effectively detect the characteristic patterns of infection and inflammation associated with MOE. By carefully assessing soft tissues, bony structures, and intracranial components, radiologists can recognize subtle changes that may indicate the presence of osteomyelitis, abscess formation, or vascular involvement. Consistent application of this structured methodology not only aids in the timely diagnosis of MOE but also facilitates appropriate management, ultimately improving patient outcomes.