The present paper reported two cases of inflammatory lesions in the parapharyngeal space. The first case was a 74-year-old female. She consulted us with a tumorous swelling of the left tonsil and surrounding area. Since a few days prior to her hospitalization, massive purulent discharge flooded the left bony external auditory canal. This finding indicated an inflammatory lesion of the parapharyngeal space. Administration of antibiotics reduced the swelling of the left tonsil and the otorrhea. The other case was a 38-year-old female complaining of pharyngeal pain and trismus. The right tonsil was enlarged and partially hardened, suggesting a neoplasm. Blood examination showed mild elevation of CRP and ESR, however leukocytosis was not seen. An excisional biopsy of the tonsil was carried out. Histological examination showed only inflammatory changes. Her symptoms were gradually decreased by a combination of the excision and the administration of sensitive antibiotics. The progressive clinical course of these cases despite the usual antibiotic therapy made their early diagnosis difficult. CT and MRI were not effective for definitative differentiation between inflammation and neoplasm in these cases. Repeat biopsies and exploratory punctures are needed to exclude the possible of neoplastic lesions in such cases.