Background: Chronic suppurative otitis media (CSOM) leads to numerous well identified complications reported by many researchers.Case report: Present case study includes 9 patients with CSOM (active squamous type) where we found infective endocarditis as a rare complication. Conclusions:The current study highlights the importance of early management of CSOM and proper cardiologic evaluation which can prevent catastrophic complications such as infective endocarditis.