<p>Adenoid cystic carcinoma is a very rare tumor occurring within temporal bone. It mainly affects the salivary glands, rarely skull base. We hereby share our experience of managing a case of adenoid cystic carcinoma of external auditory canal (temporal bone) in a 46 year old female who presented to our tertiary care centre with complaints of left sided intermittent otalgia and aural fullness for past 7 months. On otoscopic examination a swelling was found hanging from the posterior canal wall, round in shape, smooth in surface, minimum tender and doesn’t bleed on touch, with no cough reflex or pulsation. HRCT temporal bone done outside didn’t reveal any bony erosion. Patient hence was counselled and posted for left external auditory cyst excision with myringoplasty. Biopsy from the mass was send for histopathological evaluation which later revealed Adenoid Cystic Carcinoma (Cribriform type). After discussion about the case institutional tumor board comprising of otorhinolaryngologists, pathologists, radiologists and medical oncologists decision was taken of postoperative radiotherapy and regular follow up. On follow up after completing radiotherapy it was found to have good improvement. Later, patient missed follow up and after 6 months she visited us external auditory canal stenosis for which recanalisation was done and she was evaluated thoroughly and no recurrence was found. This case report focuses of early diagnosis of a rare malignancy, importance of radiotherapy in managing early stages of adenoid cystic carcinoma, multidisciplinary team effort approach to such rare disease and the postoperative or post-radiotherapy complications.</p>