The tympanic(Jacobson’s) nerve is a useful anatomical structure in the middle ear with both practical and physiological functions extending beyond its origin. The paper reviews its clinical anatomy in adults and its surgical significance. English language articles from 5 major databases and Google scholar search engine were used to identify papers outlining the anatomy of the tympanic nerve, associated pathology and surgical relevance. In the majority of cases the tympanic nerve arises from the inferior ganglion of the glossopharyngeal nerve traversing through the tympanic canaliculus into the middle ear. On the promontory it coalesces with sympathetic fibres from the carotid chain forming the tympanic plexus which has individual variability. Functionally, as well as giving off parasympathetic fibres to the parotid gland via the lesser petrosal nerve, it is a useful anatomical landmark for cochlear implantation. The surgical importance of the tympanic nerve is not only restricted to middle ear surgery; it also extends tosalivary gland disorders. The tympanic nerve remains clinically relevant to the modern otolaryngologist and as such a detailed understanding of its anatomy is crucial. The tympanic (Jacobson’s) nerve is a useful anatomical structure in the middle ear with both practical and physiological functions extending beyond its origin. The paper reviews its clinical anatomy in adults and its surgical significance. English language articles from 5 major databases and Google scholar search engine were used to identify papers outlining the anatomy of the tympanic nerve, associated pathology and surgical relevance. In the majority of cases the tympanic nerve arises from the inferior ganglion of the glossopharyngeal nerve traversing through the tympanic canaliculus into the middle ear. On the promontory it coalesces with sympathetic fibers from the carotid chain forming the tympanic plexus which has individual variability. Functionally, as well as giving as off parasympathetic fibers to the parotid gland via the lesser petrosal nerve, it is a useful anatomical landmark for cochlear implantation. of the tympanic nerve is not only restricted to mi it also extends tosalivary gland disorders. The tympanic nerve remains clinically relevant to the modern otolaryngologist and as such a detailed understanding of its anatomy is crucial.