Background <p>Inner ear enhancement on contrast-enhanced three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI reflects disruption of the blood–labyrinth barrier (BLB) and has been reported in several audiovestibular disorders. However, the temporal enhancement pattern in labyrinthine infarction remains poorly characterized.</p> Methods <p>We investigated time-dependent enhancement patterns on 3D-FLAIR MRI in four patients with labyrinthine infarction secondary to anterior inferior cerebellar artery infarction. All patients underwent comprehensive neuro-otological evaluation and contrast-enhanced inner ear MRI. Axial 3D-FLAIR images were obtained at three time points: pre-contrast, 10&#xa0;min, and 4&#xa0;h after gadolinium administration. Enhancement patterns were compared with those observed in 37 patients with non-vascular audiovestibular disorders, including sudden sensorineural hearing loss with vertigo ( <i>n</i> = 3), Ménière’s disease (<i>n</i> = 9), recurrent vestibulopathy (<i>n</i> = 14), acute unilateral vestibulopathy (<i>n</i> = 11), who underwent the same imaging protocol.</p> Results <p>All four patients with labyrinthine infarction demonstrated ipsilesional enhancement of both the cochlea and vestibule on 4-hour delayed images. Two patients also showed early enhancement confined to the cochlea on 10-minute images. By contrast, only 8 of 37 patients (22%) with non-vascular audiovestibular disorders demonstrated enhancement, which was predominantly observed on 4-hour delayed images but not detected on 10-minute images.</p> Conclusions <p>These findings suggest that 4-hour delayed enhancement is a consistent imaging feature of labyrinthine infarction, whereas early (10-minute) enhancement may occur in a subset of patients and may provide insight into the temporal evolution of BLB disruption following ischemic injury.</p>