Tuberculous otitis media is a rare condition that does not have a characteristic clinical picture. Early diagnosis helps to start specific treatment in a timely manner and prevent the development of complications. This article describes a clinical case of tuberculous otitis media in a 17-year-old adolescent. The lesion of the middle ear was the first clinical manifestation of the disease, and later a typical radiological picture of lung damage was revealed. In the case of a prolonged course of otitis media without a response to standard antibacterial therapy, it is necessary to exclude the mycobacterial nature of the disease. Special attention should be paid to patients living in areas endemic for this disease, to the examination of migrants and refugees from these regions.