Squamous cell carcinoma (SCC) of the external auditory canal (EAC) is an extremely rare malignant tumor with a prevalance between 1 and 6 cases per 1 million population. The incidence is higher in patients presenting with otological diseases (1 in 5,000 to 15,000). Certain associating factors have been described in the literature. This malignancy frequently presents with symptoms similar to a case of otitis externa or a chronic suppurative otitis media. In this paper, we present a patient who had bilateral SCC of EAC caused by radiotherapy for nasopharyngeal carcinoma. To our knowledge, our case is the fifth bilateral SCC of the EAC and the first bilateral radiotherapy related SCC of the EAC reported in the literature so far. © 2007 Springer-Verlag.