Secretory otitis media is a non-suppurative inflammatory disease of the middle ear in which eustachian tube dysfunction is the main pathogenetic basis and the most common cause. In children, due to the anatomical and physiological characteristics of the eustachian tube, the pharyngeal opening of the eustachian tube is easily blocked, resulting in impaired drainage of the eustachian tube and middle ear cavity. When the eustachian tube is dysfunctional, middle ear gas exchange and middle ear cavity oxygen partial pressure decreases, CO2 partial pressure increases, pH drops, secretion of mucus glands increases, and middle ear ooze occurs, causing secretory otitis media. Adenoid hypertrophy and chronic tonsillitis are also important causes of eustachian tube obstruction due to their inflammation, especially adenoid hypertrophy, whose mechanical compression of the pharyngeal orifice of the eustachian tube by the hyperplastic tissue has a greater impact on causing secretory otitis media in children. In addition, dysfunctional cleaning of the eustachian tube is also a cause of secretory otitis media. The ciliated structure of the mucosa of the eustachian tube prevents bacteria from entering the middle ear cavity, and cilia movement can push mucus from the middle ear cavity to the nasopharynx. Upper respiratory tract infections, especially viral infections, cause abnormal cilia function, which can lead to bacteria entering the middle ear cavity and developing secretory otitis media. In addition to the conventional application of antibiotics, hormones, tympanic chamber puncture and fluid extraction, pharyngeal tube blowing and nasal decongestant drops, the treatment of secretory otitis media in children should be comprehensive after analyzing the cause of the disease, and no single treatment method can achieve the best results. Especially for recurrent cases and children with chronic secretory otitis media, the cause must be identified. Children with nocturnal snoring can be examined by nasal endoscopy or fiberoptic nasopharyngoscopy to clarify whether the adenoids are enlarged or not. Children with chronic tonsillitis, especially preschoolers, have an active physiological function of tonsil tissue, whose main function is to produce immunoglobulins, and if tonsillitis does not occur repeatedly, tonsils should not be removed. If the tonsils are replaced by fibrous tissue, lose their physiological function, and become a “storage place” for bacteria, and affect the pumping action of the eustachian tube, the tonsils can be removed. For children with chronic sinusitis, CT examination of the sinuses should be performed to clarify the diagnosis, and conservative treatment is appropriate, with systemic application of antibiotics and local ephedrine drops to reduce mucosal congestion. If necessary, maxillary sinus puncture and irrigation should be performed in the presence of maxillary sinusitis. For children with adenoidal hypertrophy or chronic tonsillitis, chronic sinusitis and other clear causes, treatment for the cause is the key to preventing recurrence of secretory otitis media. In addition to actively treating the cause, parents should be instructed to learn how to perform indirect blowing of the eustachian tube for regular treatment at home. At the same time, the number of swallowing movements should be increased by various methods to exercise the opening and closing function of the eustachian tube. Regular follow-up of cured children is also important to prevent recurrence of otitis media.