Chronic ear disease encompasses a wide range of clinical entities amenable to medical and surgical intervention. The otolaryngologist must always consider the goals of surgery--first and foremost to achieve a safe ear. The least invasive procedure capable of eradicating disease is generally chosen. During surgery, a delicate balance has to exist between the careful preservation of function and the aggressive prevention of potentially recurrent disease. Postoperatively, thorough follow-up and good judgment are paramount in avoiding complications and preventing unnecessary additional surgical procedures.