The styloid process is a slender, cylindrical bony outgrowth located immediately in front of the stylomastoid foramen and fused to the inferior aspect of the temporal bone. The elongated styloid process is not so frequent and the styloid syndrome is a dull, nagging pain in the oropharynx, often referred to the ear and the mastoid region. The symptoms are secondary stimulation of the nerves and vessels which pass close to the tip of the process. The clinical diagnosis is certain if the elongated styloid process is palpated through the tonsillar area. Radiologic investigation give information about the length of the styloid process and medial angulation. The treatment of choice is surgical shortening of the process. Recently, the authors experienced a case of elongated styloid syndrome misdiagnosed as pharyngeal neurosis in a 28 year-old male patient.