Twenty-nine patients with chronic suppurative otitis media with intracranial complications are reviewed. The complications occurred predominantly in young patients with a mean age of 17 years. The most common complication was brain abscess (n = 20). The others were meningitis (n = 3), subdural abscess (n = 3), perisinus abscess (n = 2) and otitic intracranial hypertension (n = 1). The common pathogens were Gram-negative bacilli, especially Proteus and anaerobic organisms, respectively. The mortality rate was 7%.