Behind the optic foramen the anterior clinoid process is directed backward and medialward and gives attachment to the cerebellar tentorium .

On either side of the sella turcica is the carotid groove, which is broad, shallow, and curved somewhat like the italic letter f. It begins behind at the foramen lacerum, and ends on the medial side of the anterior clinoid process, where it is sometimes converted into a foramen (carotico-clinoid) by the union of the anterior with the middle clinoid process; posteriorly, it is bounded laterally by the lingula.

They are marked by depressions for the brain convolutions and traversed by furrows for the anterior and posterior branches of the middle meningeal vessels.

On the anterior surface of the petrous portion of the temporal bone are seen the eminence caused by the projection of the superior semicircular canal; in front of and a little lateral to this a depression corresponding to the roof of the tympanic cavity; the groove leading to the hiatus of the facial canal, for the transmission of the greater superficial petrosal nerve and the petrosal branch of the middle meningeal artery; beneath it, the smaller groove, for the passage of the lesser superficial petrosal nerve; and, near the apex of the bone, the depression for the semilunar ganglion and the orifice of the carotid canal.

A middle fossa craniotomy is one means to surgically remove acoustic neuromas (vestibular schwannoma) growing within the internal auditory canal of the temporal bone.