Acute otitis media is a common disease process, primarily seen in children. Since the introduction of vaccines, there has been a dramatic decrease in its complications, but the most common pathogens S. pneumoniae, H. influenza, and M. Catarrhalis continue to be prevalent. Treatment involves antibiotics and tympanostomy tubes, sometimes in conjunction with an adenoidectomy. Other treatment options such as steroids are controversial. Untreated acute otitis media can result in hearing loss and subsequent speech delay. However, some of its complications such as intracranial abscesses, mastoiditis, and facial paralysis, while rare, can result in serious morbidity. Timely identification and treatment are critical to limiting the morbidity and mortality of this common disease.