This study aimed to determine if there is a possible relationship concerning the presence of ponticulus posticus (PP) in patients with elongated styloid process (ESP) on three-dimensional cone beam computed tomography (CBCT) images. The presence or absence of the PP (whether partial or complete) was determined and noted as a positive or negative finding. Then, the patients with PP were evaluated for ESP. For this purpose, 3-D CBCT scanning digital images of 542 patients having ESP (247 males and 295 females) were examined retrospectively. There was a significant relationship between the presence of PP and ESP (P=.03). The results of this study suggest that there is a significant correlation between the presence of PP and ESP. To our knowledge, this is the first study investigating the relationship between the two disorders in the literature. (C) 2015 Elsevier Inc. All rights reserved.