The clinical presentation for ear complaints can often overlap with other common pediatric conditions. As such, the differential diagnosis for ear complaints is broad, warranting a thorough history and targeted physical examination. Optimizing the approach for a definitive ear examination is essential when evaluating a pediatric patient with an ear concern. A systematic approach will improve the accuracy of diagnoses and the appropriateness of management. This issue provides an evidence-based approach to the diagnosis, workup, and management of common ear complaints in pediatric patients.