Acute otomastoiditis is a potentially life-threatening condition. It is relatively uncommon in elderly patients and is usually seen as a complication of acute otitis media. Limited studies are available on this uncommon disease in the elderly, and thus the clinical course of the disease is not fully understood. Proper use of antibiotics for acute otitis media has markedly decreased the incidence of acute otomastoiditis. We describe a case of a 76-year-old male with acute otomastoiditis complicated by cerebellopontine angle epidural abscess who presented with a chief complaint of sudden onset of global aphasia, which is an unusual presentation for acute otomastoiditis. The patient eventually required medical and surgical intervention. To the best of our knowledge, acute otomastoiditis presenting with sudden onset of global aphasia has not been previously described in the literature. This case illustrates how multidisciplinary team involvement is vital in the management of these uncommon cases.