Myeloid sarcoma is a rare solid, extramedullary tumor composed of immature granulocytes, occurring in a granulocytic leukemia. In rare cases, they can represent the initial manifestation of a relapsed form in patients with acute myelogenous leukemia in remission status. There have been only a few reports of myeloid sarcoma involving the temporal bone. We report a case of facial nerve paralysis caused by temporal bone myeloid sarcoma as the presenting symptom of leukemic relapse in a 27-year-old female, who was affected by acute myelogenous leukemia.