OBJECTIVE To determine the frequency of Otitis Media with Effusion (OME) in children with recurrent upper respiratory tract infections. METHODS A descriptive study. METHODS Combined Military Hospital, Gujranwala, from September 2003 to September 2005. METHODS Children of either gender suffering from more than 2 episodes of upper respiratory tract infection in the last 12 weeks were studied. The inclusion criteria were mild intermittent ear pain, fullness or "popping" of the ear drum; poor response to normal speech, inattentiveness, behavioural changes; irritability, sleep disturbances; balance problems and poor school performance. Diagnosis of OME was confirmed by pneumatic otoscopy while tuning-fork tests, tympanometry, pure tone audiometry were used as adjunct investigations. Results were described in percentage and 95% confidence interval was determined. RESULTS Out of the 350 referred cases, pneumatic otoscopy by otolaryngologists diagnosed OME in 147 (42%, 95% CI=37.9-47.1). Out of these, 112 (76%) had retracted tympanic membrane, 25 (17%) had bulging of tympanic membrane and 10/147 (6.08%) cases showed dullness of tympanic membrane with no additional features. Tympanometry confirmed fluid behind the tympanic membrane in 145/147 (98.6%) cases. Tuning-fork tests showed negative Rinne's test in 122 (83%). Pure tone audiometry diagnosed deafness in 138/147 (93.8%) cases. CONCLUSIONS OME with hearing loss is common in children having recurrent upper respiratory tract infection and nonspecific ear-related symptoms.