Various types of traumatic injuries of the middle ear structures can be caused by either direct or indirect forces through the external auditory canal, auditory tube, and by forces transmitted indirectly through the skull. Diagnosis of middle ear injuries should be established by precise history taking, audiological tests, x-ray examinations including polytomography and high resolution CT. The most common trauma of the middle ear is perforation of the tympanic membrane due to blunt trauma, penetrating injury or barotrauma. Traumatic perforations of the tympanic membrane tend to heal rapidly but the long standing perforations can be repaired by surgery or by cauterization with several kinds of patches. Discontinuity of the ossicular chain is not always readily diagnosed. However, in any doubt of ossicular injuries surgical exploration of the middle ear must be considered. The methods of repair should be versatile in order for continuity to be re-established. Rupture of the inner ear windows can be caused by even minor traumas such as head concussion, baratrauma, sneezing or coughing. Exploration of the middle ear cavity is mandatory and sealing of the ruptured round and oval window have been recommended.