Background: Chronic suppurative otitis media (CSOM) represents a significant health challenge worldwide, particularly in underdeveloped and developing regions, including India. This study aimed to evaluate the risk factors associated with CSOM in pediatric populations. Materials and Methods: A total of 345 children aged 6–15 years, comprising both male and female participants, were included in the study. Detailed otoscopic evaluations and pure tone audiometry were conducted. Clinical and environmental risk factors predisposing to CSOM were documented. Results:Among the participants, 194 were male and 151 were female. Risk factors identified included families with more than five children, paternal smoking, maternal illiteracy, bathing in contaminated pond water, family history of ear discharge, and residing in overcrowded households. Socioeconomic status analysis revealed that majority belonged to upper-lower income category. Additional contributing factors included upper respiratory infections, nasal allergies, chronic tonsillitis, and sinusitis. Conclusion:The study highlights that key risk factors for CSOM in children include large family size, exposure to paternal smoking, low maternal education levels, bathing in polluted water, familial predisposition to ear infections, and overcrowded living conditions.