Classically, teaching of otological micro procedures is achieved by cadaveric dissection of the temporal bones, achieved by attending expensive temporal bone dissection courses. The difficulty in acquiring cadaveric specimens and the cost of courses has led to the development of alternative techniques. The aim of this study is to evaluate the efficacy of using virtual reality temporal bone simulation in training otolaryngology residents for mastoidectomy procedures. Four senior residents were evaluated during six canal wall down mastoidectomy procedures. Three of these procedures were done conventionally. The other three procedures were preceded by virtual reality simulation 1 day before the operation. In simulated cases, the residents scored higher on the global rating scale and task-based checklist, and were faster and more confident. Further, fewer instructions were required during the actual operation. This outcome is encouraging for the utilization of virtual reality simulation in otolaryngology residency training. Further studies should be performed on a larger number of simulators and surgical procedures to validate our results.