Forty-six cases of glomus tumor involving the middle ear are presented. The average follow-up period is 7.1 years. Surgical success rate is 73 percent and radiation is 20 percent. As a secondary modality of therapy for persistent or recurrent tumors, the surgical success rate was 71 percent and radiation was 40 percent. The therapeutic failures are described by anatomic location. There were two tumor related deaths. The treatment of choice for glomus tumors and for tumor recurrences or persistences, providing that they do not invade the intracranial cavity, is surgical. A wide excision (including a jugular bulb and vein resection when indicated) is advocated.