Aim: currently clarification of the course characteristics, diagnosis and treatment principles of tuberculosis otitis media. Materials and methods: The study included 6 cases (8 ears) of tuberculosis otitis media and mastoid process from 2015 to 2020. Clinical, radiological, bacteriological, pathomorphological studies were used for diagnostics. Results: Primary localization of tuberculosis in the middle ear was found in 2 patients. In 4 patients tuberculosis middle otitis associated with lung affection. The disease manifested in the form of purulent perforated otitis media with a polymorphic otoscopic picture in all examined patients. The terms of the diagnosis were from 6 months to 1.5 years since the onset of the disease. This indicates the complexity of diagnosing the tuberculous etiology of the middle ear disease.