We report a case of Granulocytic Sarcoma (chloroma) with acute mastoiditis in a 14-year-old male. The patient was brought to our clinic because of left facial nerve palsy and acute bilateral otitis media. He was diagnosed as having acute mastoiditis, and underwent left mastoidectomy. One week later, however, leukocyts increased and the wound did not heal. A mass lesion in the mastoid was detected on MRI. We biopsied the mastoid and found Granulocytic Sarcoma (chloroma). Thereafter, the patient underwent chemo- and radiation therapy, but died due to the general deterioration of his condition. In this case, pathological examination and MRI were useful for establishing the final diagnosis.