Kaposiform hemangioendothelioma (KHE) is a locally aggressive vascular tumor. It is classified by the World Health Organization (WHO) as intermediate malignant.1 Some cases have been associated with Kasabach-Merritt syndrome (KMS), a phenomenon defined by thrombocytopenia and coagulopathy, increasing the risk for life-threatening hemorrhage.1,2 Typically, KHE is found in pediatric patients.1 The most common locations for presentation are the extremities, trunk, and retroperitoneum. A smaller number of cases have been reported in the head and neck.3 To our knowledge, there has been only 1 previous report of KHE in the internal auditory canal.4 We present what we believe to be the youngest patient with an internal auditory canal KHE.