Purpose The study examined the association between mastoid pneumatization (MP) volume and the existence of foramen Huschke (FH). Methods Cone beam computed tomography (CBCT) images of 1117 patients (2234 mastoid regions) were analyzed. The prevalence of FH was calculated. The association of MP volume calculated in 83 patients (48 women, 35 men) with sex, side, and the existence of FH analyzed.Ttest and Pearson's Chi-square test were used for statistical analyses. Results FH was observed in 223 (20%) patients. FH was unilateral in 141 (63.7%) patients (74 left-sided, 68 right-sided) and bilateral in 81 (36.3%) patients. Six patients with FH had herniation into the external auditory canal. MP volume was significantly greater in females (p = 0.016). Additionally, MP volume was significantly greater in patients having FH (p = 0.009). Conclusion It is possible to speculate that the volume of MP, which is in close neighborhood with the external auditory canal, somehow affects the existence of FH located in the tympanic segment.