It is a common experience that radiology reports on the CT scans of the temporal bones do not always reach a diagnosis. Various studies have produced differing results in that detailed information may not be necessary to help reach a diagnosis by the radiologist and there are no national guidelines to this effect. However, the general consensus is that comprehensive rather than scanty information is helpful. In this two cycle audit the authors assess the extent to which accurate diagnosis was made in relation to CT temporal bone requests, firstly with random clinical information and then in the second cycle of the audit, with regulated information which unfailingly included the site, the symptoms, past medical history, audiological results, specific clinical questions asked, any suspected complications and mention of differential diagnosis. It was noted that CT reports indicating a diagnosis or excluding an important complication increased from 52 to 94 and the need for further clinical information or repeat of the imaging dropped from 12 to two. The factors which played the most significant role in this were mention of a differential diagnosis in the request, the clinical questions, the audiological findings, duration of signs and symptoms and the patient’s history. The striking aspect of this audit is that the same three neuro-radiologists delivered the reports in both cycles of this audit and were not aware of the audit itself, thus removing the element of bias quite convincingly. The study therefore strongly illustrates that, regardless of some reports in the literature stating otherwise, detailed information including the factors mentioned helps arrive at a better diagnosis and save repeat imaging.