Pain behind the ear when swallowing may be related to ear trauma or caused by acute pharyngitis or acute tonsillitis. 1. Ear trauma: If the ear is suddenly hit or struck by an external force, resulting in ear trauma, especially after causing ulceration of the external auditory canal, it is likely to cause localized infection, which may manifest as pain behind the ear when swallowing. 2. Acute pharyngitis: acute inflammation of the pharyngeal mucosa, submucosal tissue and its lymphatic tissue. It is usually caused by viral infection, bacterial infection, and stimulation of physical and chemical factors. At the beginning, the pharynx is dry and burning. Followed by pharyngeal pain, which is more pronounced during empty pharynx than during eating, and the pain can be radiated to the ear. 3. Acute tonsillitis: acute non-specific inflammation of the palatine tonsils. Local symptoms are severe sore throat, mostly accompanied by swallowing pain, and the pain often radiates to the ear. Enlarged lymph nodes in the angle of the jaw may be tender to touch. Pain behind the ear when swallowing may also be caused by ear diseases, it is recommended to consult the hospital, diagnosis and treatment.