Many people have experienced ear pain, and in some cases the pain is so intense that it seriously affects their normal life. Does ear pain mean otitis media? We all know that the ear is composed of the outer ear, middle ear and inner ear. Therefore, the cause of ear pain can also be caused by inflammation and tumors in the outer and middle ears. For different age groups, ear pain is often indicative of different diseases. In children, earaches are often accompanied by fever and upper respiratory tract infections (e.g. nasal congestion, runny nose, snoring in bed, etc.). If the auricle is not red and does not allow others to touch it, it is often indicative of acute otitis media. It is important to note that children with acute otitis media do not necessarily have pus in the early stages, but once pus is flowing, it is clearly an inflammation of the middle ear. Moreover, the systemic symptoms and localized pain are often relieved after the flow of pus. This is due to the fact that the pressure on the local nerve is reduced after the pus is removed, and at the same time the absorption of toxins is reduced. When the causative organism is more virulent, or when the child’s resistance is poor, there is a possibility of simultaneous inflammation of the outer and middle ears. In adults, otitis externa may be present if there has been digging with a sharp object (such as a metal ear pick) or water in the ear prior to the onset of ear pain, and if the pain is aggravated by pulling on the auricle or pressing on the ear screen; if there is pus in the ear, otitis media may be present. In the clinic, we often encounter patients who tell us that they have pus in their ears because they have water in their ears. In this case, the patient often has a perforated eardrum, which is why the pus flows after water ingress. Normally, when the eardrum is intact, water in the ear does not cause pus. Finally, it is important to emphasize that for patients with diabetes mellitus, once ear pain occurs, they should go to the hospital promptly. Due to the effects of diabetes mellitus, the environment of the external ear canal has changed and resistance has decreased significantly, which can easily lead to the growth of bacteria and fungi, causing inflammation of the outer and middle ear, and even serious complications such as temporal bone osteomyelitis (malignant otitis externa), so it is important to go to the hospital promptly.