Otitis media is a multifactorial illness that is the most common childhood disease that requires physician care, and its resultant health care costs are high. The established role of infection in the pathogenesis of otitis media has promoted aggressive antimicrobial therapy with specific antibiotic protocols for acute otitis and prophylactic antibiotic regimens for chronic or recurrent acute otitis media. Even though these antibiotic regimens have been widely used, there has not been a decreased incidence of otitis media and its complications. The possibility that allergy contributes to chronic or recurrent otitis media especially in children older than 3 years has been debated for years. If a causal relationship between allergic respiratory diseases and middle ear disease were to be established, then one would anticipate that anti-allergic therapy would reduce the morbidity and health care costs associated with otitis media.