A cross-sectional, clinical and epidemiological study was undertaken among 627 primary school children (rural 145, urban 482) to compare the common ear morbidity pattern between an urban slum of kolkata and a rural area of Hooghly. Middle ear pathology was found to be present in 20% and 12.6% among rural and urban students respectively. Cerumen in the external auditory canal was the commonest clinical finding in both the areas and was found to be present in 35.86% of rural and 30.70% of urban population respectively. Smoke nuisance, bathing in open ponds and overcrowding were some of the predisposing factors causing ear diseases, like chronic suppurative otitis media and serous otitis media.