Acute otitis media is one of the urgent problems of pediatric otolaryngology. Its relevance is predetermined by the wide spread of the disease, especially among young children, the frequency of prescribing antibiotic therapy and the potential threat of severe complications. Pneumococcus is the most frequent causative agent of acute otitis media. Having introduced pneumococcal vaccination the incidence of acute otitis media has significantly decreased in many countries. The aim of the study was a retrospective analysis of the incidence of acute otitis media according to the Rostov ENT clinic for the period from 2012 to 2018. There is a significant annual increase in the number of children with moderate and severe forms of the disease. In 2018 the proportion of children under 3 years hospitalized with acute otitis media tended to reduce, that fact cannot be regarded as a result of vaccination, since the incidence of acute otitis media is subject to significant spontaneous fluctuations and depends on the epidemiological characteristics of viral respiratory infections.