The otitis media with effusion (OME) is an effusion-filled middle ear. However, no other symptoms indicate an acute infection. The middle ear cavity fills with non-purulent fluid of various viscosities when the Eustachian tube dysfunctions or blocks. Middle-ear effusion is a critical diagnostic requirement for OME. Fever, otalgia, and tympanic membrane erythema appear; these symptoms may not be present in OME, but hearing loss is the most noticeable. Chronic otitis media with effusion is diagnosed when effusion remains behind the eardrum for 12 weeks or more. Topical nasal or oral decongestants, antihistamines, and corticosteroids are ineffective for OME and, therefore, not recommended for treatment. Management of OME usually starts with observation and close monitoring, with tympanostomy tubes indicated primarily for children with persistent effusion and hearing loss, speech and language delay, or learning difficulties. Adenoidectomy is considered in children aged four years or older with recurrent OME and in children of any age with OME and nasal symptoms. Topical antibiotics are the recommended treatment for tympanostomy tube-associated otorrhea.