OBJECTIVE Review clinical manifestations, investigation, and treatment of tuberculosis of the middle ear. METHODS A retrospective review of six cases diagnosed as tuberculosis of the middle ear at a tertiary referral center was included in the present study. The outcome measures were history, clinical manifestations, investigation, and treatment were reviewed in the medical records. RESULTS The authors retrospectively reviewed data of our patients diagnosed as tuberculosis of the middle ear. It has been found that the most common manifestation is chronic otorrhea. Investigations are variable such as histopathology, tissue culture, or polymerase chain reaction for identification of tuberculosis. Treatment is mainly medication, however, surgery is considered for histopathology in selected cases. CONCLUSIONS Tuberculosis of the middle ear is a rare disease that requires high index of suspicion for diagnosis due to the variety of clinical manifestations. Identification of tuberculosis is a key for diagnosis and treatment.