Аннотация:Objective This article aims to show the qualitative TNF‐alpha expression on acquired cholesteatoma behavior and the recurrence prognostic factor. Method We retrospectively selected 2 groups of patients with acquired cholesteatoma who underwent open tympanomastoidectomy to remove the disease: the first group had recurrence after at least 2 years, and the second group had the disease under control over 4 years. Results Immunohistochemistry was done using a TNF‐alpha receptor marker in both groups and was evaluated by 3 observers who followed the patterns according to the relationship between the reagent expression and the epithelium. The 0 level means no reagent expression, the + level means that a third were dyed, the ++ level means more than two thirds were dyed, and the +++ level means the fullest extent of the epithelium was dyed. The mean expression of TNF‐alpha was slightly higher in the group with recurrence than in the control group, respectively 1.7 + 1.4 +, but there was not detected a statistically significant difference between the groups ( P =. 456). Conclusion Although several articles show TNF‐alpha action bone destruction in cholesteatoma cases in vitro, the qualitative expression of TNF‐alpha was not a good predictor in cholesteatoma recurrence.