Otogenic thrombosis of the lateral sinus, which has become rare since the use of antibiotics, nevertheless still poses diagnostic and therapeutic problems. Based on 4 cases treated at the University Teaching Hospital in Tours since 1982, the authors study the various clinical and paraclinical elements in the diagnosis, stressing the value of CT examination using contrast. Management is then proposed in diagramatic form: the indication for surgery depending on the efficacy of antibiotic therapy and internal jugular vein ligation being required in the event of septic emboli manifest cervical signs.