There were 858 instances of otitis media studied in a private pediatric practice over a 2-year period; these cases were studied by aspiration and culture of middle ear fluid. Clinical correlations were made with observations of bacterial etiology. Pneumococcal otitis media was far more likely than Hemophilus influenzal otitis to be associated with severe pain and high fever. H. influenzal otitis media tended to be associated with little fever or pain and was more apt to be bilateral. The distribution of etiologic agents in the study was similar to that of previously reported series from this county. However, the previously reported decrease in incidence of H. influenza in patients over 3 years of age was not apparent in our series.