A retrospective study of 9 cases of tuberculous otitis media with mastoiditis was carried out in a clinical point of view. Three of them were presented in a previous report. All pathological tissues obtained from chronic ear surgery should be prepaired for histopathologic examination. The incidence of tuberculous otitis media is 1.5% of chronic suppurative otitis media and it is much higher in children. The following conditions are suggestive of tuberculous otitis media in chronic suppurative otitis media ; 1) Known pulmonary tuberculosis. 2) Poor response to ordinary medication and/or extensive granulation tissue in the middle ear, especially in children. 3) Incidious painless onset with much worse hearing loss than its pathological lesion. 4) Delayed hearing of postoperative wound with formation of granulation tissue and purulent discharge. Direct smear of culture of the discharge and histopathologic examination of the granulation tissue are helpful to confirm the diagnosis. The use of aminoglyosides needs special care in case of unilateral hearing from tuberculous origin.