Accurate diagnosis of OM is important but often difficult. To enhance the likelihood of accurate diagnosis, pneumatic otoscopy is the preferred method of examination generally available to clinicians. Findings by pneumatic otoscopy should be coupled with the presence or absence of symptoms and signs to delineate a diagnosis of AOM or OME. Tympanometry can be a useful adjunct in the clinical assessment of middle ear effusion. Audiometry is particularly important for patients with recurrent or chronic middle ear disease.