Tuberculous otitis media is a very rare disease in extrapulmonary tuberculosis and in chronic otitis media nowadays. The characteristic signs seem to have altered from the past ones. And the suspicion index is very low that there is often a considerable delay prior to diagnosis. This might result in irreversible complications such as hearing loss, facial nerve paralysis and labyrinthitis. It is difficult to be defined by culture, so many patients with tuberculous otitis media are subjected to have surgery without a correct etiologic diagnosis. Therefore bacteriologic study of secretion and pathologic examinations of biopsied tissue are mandatory. We report one year and 11 months old boy with tuberculous otitis media having painful otorrhea and perforated tympanic membrane diagnosed by histologic finding and polymerase chain reaction(PCR). And we would like to emphasize the fact that tuberculous otitis media must be considered in the differential diagnosis of persistent suppurative otitis media despite appropriate antibiotic therapy considering the increasing tendency in incidence of Tuberculosis in Korea these days.