Although intracranial otogenic complications occur less frequently than in the preantibiotic period, their mortality rate is still relatively high. On the basis of some personal clinical observations made during the last decade attention has been drawn to the most common intra- and extracranial otogenic complications (posterior fossa syndrome, labyrinthine fistula, labyrinthitis, facial palsy) mostly due to cholesteatoma, and a less frequent intracranial complication occurring mainly in children (otitic hydrocephalus) caused by chronic otitis media. It may therefore be concluded that otitis media must still be considered a dangerous disease, necessitating early diagnosis, intensive therapy and in case of a cholesteatoma complete and early eradication.