Otitis media is the most prevalent illness affecting the pediatric population. Each year in the United States there are 30 million visits to pediatricians for the treatment of otitis media infections and their sequelae, at a cost of $1 billion in health care dollars. This article offers a discussion of the factors that predispose children to otitis media, with emphasis on diagnosis and treatment. The clinical presentation, disposition and associated morbidity of common complications are also discussed.