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Patients with baseline temporal bone CT scans acquired by using a z-axis ultra-high-resolution protocol and a follow-up scan by using the ultra-high-resolution–iterative reconstruction technique were identified. Images of left and right temporal bones were reconstructed in the axial, coronal, and Poschl planes. Spatial resolution was comparable (Poschl) or slightly better (axial and coronal planes) with ultra-high-resolution–iterative reconstruction than with z-axis ultra-high-resolution. Paired t test indicated that noise was significantly lower with ultra-high-resolution–iterative reconstruction than with z-axis ultra-high-resolution.