Five cases of tuberculosis otitis media are reported. The clinical picture and the hazards of diagnosis are discussed. Although not a common cause of chronic otitis media, tuberculosis of the middle ear cleft is an entity one should recognize especially when a chronic suppurative ear disease does not respond to the usual treatment. The signs and symptoms are non-specific. Altering features include racial predisposition, contact or personal history of past or present tuberculosis, chronicity, development of a facial palsy and the pale granulation tissue found at the operation.