The association between second-hand smoke exposure and adolescent middle ear problems has not been examined. A random sample stratified by region was drawn from a list that included approximately 40% of all Florida households with children in grades 4-7. A total of 785 Florida adolescents initially enrolled in the 4th-7th grade participated in three telephone interviews conducted over a 24-month period. At the round 3 interview, 10.3% of participants reported one or more earaches within the previous 30 days. Several second-hand smoke exposure questions asked at each of the three interviews were associated with the number of reported earaches. Stepwise polytomous logistic regression indicated that parental smoking inside the home reported at the round 3 interview was associated with the number of reported earaches (OR=3.11, 95% CI=1.70-5.66). Once this variable was selected, none of the other second-hand smoke exposure variables offered additional predictive value (p>.1). None of the non-second-hand smoke exposure variables, including the participant's own history of tobacco use, had any association with the reporting of earaches (p>.05). Second-hand smoke exposure is associated with self-reported earaches in adolescents. These findings should be replicated in a study in which clinical measures of middle ear function are performed.