Acute otitis media and otitis media with effusion are commonly encountered by both general practitioners and specialists. The diagnosis of otitis media requires a focused history and accurate physical examination. Unfortunately, many practitioners are either unaware of the criteria needed to make the diagnosis, or they incorrectly perform or misinterpret the physical examination. We review the pertinent historical and physical examination findings needed to accurately diagnose otitis media. Additionally, we examine the accessory tests that might help make the correct diagnosis in difficult cases. Finally, we address the issues involved in ensuring that both current and future physicians are appropriately trained in the diagnosis of this common illness.