Introduction: With the advent of modern-day antibiotics, the complications of otitis media have become less common but patient do present with complications. It is crucial to recognise otitis media with complications early and treat it appropriately. Herein, we present our institution’s experience with patients who required emergency surgical intervention for complications of otitis media. Aim: This study aimed to analyse the management of CSOM-related problems and their diverse clinical manifestations. Results: A total of 4 patients who underwent surgery for complications of otitis media were included in the study. Out of the 4 patients, 3 patients were admitted in the casualty. Otalgia, otorrhoea, headache and fever were the main presenting symptoms.Mastoidectomy and drainage of abscess through the mastoid,was the main surgical approach. 1 patient required craniotomy. The mean length of hospital stay was 2-4 weeks. All 4had residual conductive hearing loss; 1 patient with facial palsy had full recovery. Conclusion: Otitis media can still result in serious complications in the post-antibiotic era. Patients with otitis media should be monitored, and prompt surgical intervention should be performed when necessary to attain good outcomes.