We have undertaken the analysis of medical records of the patients presenting with major otogenic intracranial complications (OICC) including purulent meningitis, brain or cerebellum abscess, and thrombosis of sigmoid sinus. The presence of isolated and combined variants of otogenic intracranial complications was documented in 112 (43%) and 148 (56.9%) patients, respectively. The development of OICC in 80% of the patients was associated with exacerbation of chronic suppurative otitis media; in the remaining 20% of the patients OICC were the consequences of acute suppurative otitis media. Thrombosis of sigmoid sinus as an independent otogenic intracranial complication was documented in 17.5% of the patients while 42.5% of the cases required the treatment by an interdisciplinary team of specialists with the participation of an otorhinolaryngologist, neurologist, intensive care and other professionals. Such approach partly accounts for the relatively low (10.6%) mortality rate among our patients with OICC.