With the striking decrease in the incidence of tuberculosis in the last few decades, tuberculous otitis media has become a rare disease. The authors experienced four cases of tuberculous otitis media during a one year period from January, 1991 to December, 1991. In this series, all patients were the primary type. Classically widely known clinical findings of tuberculous otitis media, such as multiple perforations of the tympanic membrane, are not consistent with the clinical findings reviewed here. It was found that considerable hearing loss, abundant pale necrotic granulations, and an eroded malleus handle are constant findings and appear to be important clinical features of this disease. Facial weakness accompanied three patients (75%), and symptoms of inner ear involvement were present in three cases (75%). The histopathological study seems to be the most reliable means of a definitive diagnosis, and tuberculosis should be considered in the differential diagnosis of chronic ear infection.