Summary 1.The pathways of infection from the middle ear to the labyrinth, sinus, and cerebellum are discussed briefly. 2.A case of suppurative middle ear infection with labyrinthitis, sinus thrombosis, and cerebellar abscess with herniation is reported. 3.The presence of a hernia at the site of the mastoid wound is especially noted. 4.Plastic repair of the hernia was considered and after consultation with a neurosurgeon was decided against because of the danger of complicating meningitis. Summary 1.The pathways of infection from the middle ear to the labyrinth, sinus, and cerebellum are discussed briefly. 2.A case of suppurative middle ear infection with labyrinthitis, sinus thrombosis, and cerebellar abscess with herniation is reported. 3.The presence of a hernia at the site of the mastoid wound is especially noted. 4.Plastic repair of the hernia was considered and after consultation with a neurosurgeon was decided against because of the danger of complicating meningitis.