Treatment of chronic otitis media includes conservative treatment and surgical treatment. Conservative treatment mostly uses drugs and physical therapy, with the aim of creating conditions for surgical treatment in order to obtain better postoperative results. In recent years, with the development of medical science, ear microsurgery techniques, otologic imaging, otologic hearing function tests and anesthesia techniques have been developed rapidly. More importantly, people’s understanding of middle ear anatomy and physiology has become more profound, the assessment of the middle ear has become more perfect, and surgical treatment of otitis media has become more refined and precise. The surgical treatment of otitis media has become more sophisticated and precise, and has evolved from simply removing the lesion to not only removing the lesion but also improving the patient’s hearing function, thereby improving the patient’s quality of life. Depending on the severity of the lesion, the lesion can be removed and the hearing reconstructed at the same time, which is known as stage I surgery, or the lesion can be removed and the hearing reconstructed in two complete surgeries, which is known as stage II surgery. Theoretically, the second-stage surgery will bring better hearing results than the first-stage surgery. Currently, in developed countries in Europe and the United States, second-stage surgery has become the mainstream approach, and nearly 80% of patients with otitis media have undergone second-stage surgery, resulting in better hearing outcomes. Therefore, in the long run, second-stage surgery is the future trend of surgical treatment for otitis media.