Cholesteatoma otitis media is a type of otitis media that is not a true tumor, but is characterized by destruction of the surrounding bone, with the most dangerous complications being meningitis and brain abscess, in addition to serious intracranial and extracranial complications. Intracranial complications caused by cholesteatoma otitis media usually include epidural abscess, subdural abscess, otogenic brain abscess, otogenic meningitis, and sigmoid sinus thrombophlebitis. Epidural abscess is the most common intracranial complication and the milder one, lacking typical symptoms, with no obvious symptoms or with only mild headache on the affected side. Otogenic meningitis generally presents with high fever, headache, vomiting, severe irritability, twitching of limbs, drowsiness and delirium in severe cases, and respiratory rhythm disturbances in advanced stages, often leading to death due to respiratory and cardiac arrest from brain herniation. Brain abscess is a serious complication of middle ear cholesteatoma, with early manifestations of malignant chills, fever, headache, vomiting, and headache as the main symptoms. In the late stage of abscess, ventriculitis occurs when the abscess breaks down, eventually leading to fulminant, diffuse meningitis, or brain herniation leading to death. Once cholesteatoma-type otitis media is diagnosed, patients are advised not to hesitate to actively undergo surgery to avoid serious intracranial complications that can endanger life.