Secretory otitis media is a non-purulent inflammatory disease of the middle ear characterized by fluid accumulation in the middle ear and hearing loss. It is also clinically known by different names such as exudative otitis media, non-purulent otitis media, mucus otitis media, catarrhal otitis media, tympanic effusion, plasmacytosis, plasmacytosis-mucus otitis media, and aseptic otitis media. It is the most common disease of the ear, nose, and throat in children because of its prevalence and high incidence during the child’s development. Secretory otitis media can cause hearing loss and affect speech and language development in children and should be treated with high vigilance and prompt observation. In adults with unilateral lesions, the cause should be clarified as early as possible to exclude occupying tumors in the nasopharynx and surrounding spaces, and to provide early relief of symptoms and improve quality of life. After upper respiratory tract infection, ear stuffiness and hearing loss are the main symptoms. Because the symptoms are hidden during the onset of the disease, most of them are not obvious except for partial hearing loss and other symptoms such as ear pain, and because children often have unclear complaints due to communication, they are often not easily detected by parents and ignored. When suffering from otitis media, infants and children often do not show any behavioral abnormalities. Preschool-age children most often ignore their parents’ calls, but parents often mistakenly think that their children are inattentive and do not pay attention to them; school-age children have difficulty hearing lectures during class and watch TV at a high volume. Parents only find out when their child’s hearing is significantly affected, which often delays diagnosis and treatment. Children’s susceptibility to otitis media is related to the special anatomy of the nasopharynx and its developmental process. Compared to mature adults, the nasopharyngeal canal is relatively short, wide, and straight, making it easy for nasopharyngeal secretions to reflux into the middle ear and cause inflammation. If a newborn baby is not nursed properly, especially if he or she is artificially fed with a bottle in a flat supine position, the milk will accumulate in the nasopharyngeal cavity and enter the middle ear via the eustachian tube, causing otitis media. The clinical manifestation of secretory otitis media is mainly hearing loss. The resulting complaints are mostly stuffy and occlusive sensation in the ear, tinnitus, and the sound of water can be heard by shaking the head, which can vary with the change of body position. Very rarely, it can be accompanied by mild ear pain. Specialist otologic examination reveals an invaginated tympanic membrane with reduced mobility, amber or darkened tympanic membrane, and sometimes planes of air and fluid or bubbles. A typical audiogram shows conductive deafness in the presence of poor air and bone conduction, and a type B tympanic chamber pressure map. Adults may complain of stuffy ears or hearing loss, but children often do not, especially infants and toddlers who are not yet able to speak. If parents are observant, they can see that infants and toddlers often show poor response to peripheral sounds, inability to turn their heads accurately to the source of sound, repeated ear scratching, and irritability. Even if the child does not complain of hearing loss, the family may notice inattentiveness, changes in behavior, poor or no response to normal conversation, and always turning up the sound when watching TV or using hearing devices. If parents find that the child has the above abnormalities, they should go to the hospital as soon as possible, and the doctor can make a clear diagnosis based on the medical history and specialized examination, combined with the tympanic chamber conductivity map and acoustic reflex, ear microscopy or endoscopy. In infants and children, otitis media with secretion should be differentiated from acute otitis media. Inadequate treatment of acute otitis media can lead to otitis media with secretion. Acute otitis media has an acute onset and a short duration. Patients may have severe ear pain, and after the ear pain is relieved or disappears, symptoms such as pus flowing from the ear may appear, which may be accompanied by systemic symptoms such as fever and mental discomfort. In secretory otitis media, the duration of the disease is longer, and the main symptom is ear stuffiness, and the ear pain is not obvious, or even no ear pain at all. Secretory otitis media has a certain rate of self-healing, and the rate of self-healing is even higher in infants and children. The child should be closely monitored and followed for at least 3 months before invasive treatment is given, with conservative treatment. For non-risk children, a period of observation and follow-up is not harmful, and parents should be informed that the child should be reviewed periodically, and that otoscopy and tympanogram are sufficient for review. In the case of untreated otitis media, it is important to treat it promptly, otherwise it can cause permanent conductive or sensorineural deafness. If conservative treatment is not effective, effective treatment for secretory otitis media such as aspiration of fluid in the tympanic chamber and tympanic membrane placement can be used. It is also important to pay attention to the treatment of the causes of secretory otitis media, such as adenoid hypertrophy, nasal polyps, and nasopharyngeal tumors.