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Langerhans’ cell histiocytosis (LCH) is a rare group of diseases characterized by abnormal clonal proliferation of Langerhans cells in one or more systems. LCH can occur in any system. We report a case of bilateral otologic LCH that presented as a case of mastoiditis. Despite multiple courses of antibiotics, there was no improvement. Subsequent excision biopsy of a postauricular mass confirmed the diagnosis of LCH. The patient responded well to chemotherapy