Photon counting CT allows for improved spatial and contrast resolution as compared to traditional energy integrating detector CT. Photon counting CT offers markedly improved visualization of previously described structures, as well as those that were previously beyond the resolution of imaging. Although the anatomical details of the external ear and middle ear structures have been described previously, the rich detail of these structures has not been comprehensively reviewed in the radiology literature. The microarchitecture of the middle ear ossicles and bony protuberances are particularly well visualized on photon counting CT. This manuscript updates the existing literature with a detailed anatomical review of external ear and the middle ear on temporal bone CT.ABBREVIATIONS: EID, energy-integrating detector; PCT, photon-counting computed tomography.