Summary Acute otitis media (AOM) is the inflammation of the middle ear cleft of rapid onset with the presence of local and general signs and symptoms of inflammatory reaction associated with purulent effusion in the middle ear. Acute otitis media is one of the most frequent diseases in young children, its incidence appears highest between 6–18 months of age. Usually it is caused by ascending infection from the nasopharyngs through the Eustachian tube. Both bacterial and viral infections are implicated. Most common bacterial pathogens are: S. pneumoniae, H. influenzae, M. catharralis. Diagnosis is based on otoscopic examination. In otoscopy bulging tympanic membrane Has highest predictive value for AOM. In majority of children above the age of 2 years spontaneous resolution of AOM can be observed. For this reason “watchful waiting” strategy is recommended which means limiting management to adequate pain relief and introducing antibiotics only in children who fail to improve. Antibiotic are indicated for children <6 months of age, with severe course of disease – high fever and vomiting, discharge from the ear, bilateral AOM, from the group of risk of abnormal clinical course (Down syndrome, cleft palate, recurrent AOM etc.) and lack of spontaneous improvement after 24–48 hours of symptomatic treatment. The preferred antibiotic is amoxicillin. Myringotomy is reserved for severe cases with potential or confirmed complications, lack of response on antibacterial therapy, patients with immunological deficiencies or when microbiology is strongly required.