The Finnish guidelines on the management of acute otitis media in outpatient children have been revised according to the latest published evidence. Effective treatment of ear pain is the key target of early medical intervention. The correct diagnosis of acute otitis media is of crucial importance to its management. When the diagnosis is certain, antibiotic treatment is recommended as a rule, because antibiotics shorten the time to the resolution of symptoms and middle-ear effusion, and because no individually applicable criteria are available to guide the optimal use of antibiotics. Amoxicillin and penicillin remain the primary drugs recommended for the treatment of acute otitis media.