A hundred and forty patients with destructive pulmonary tuberculosis who suffered concurrently from purulent otitis were examined. Of them, 7 (5%) patients were found to have tuberculosis of the middle ear and to have Mycobacterium tuberculosis in the sputum and otic discharge. These 7 patients were diagnosed as having disseminated destructive pulmonary tuberculosis for as long as 10 years. Tuberculosis of the middle ear was regarded as a secondary disease that occurs hematogeneously as most patients were observed to have in the lung active tuberculosis and dissemination foci throughout the lung fields with significant signs of tuberculous intoxication when tuberculous otitis was detected. Clinical cure of tuberculosis of the middle ear was noted in 2 patients; a stable dry perforation of the tympanic membrane was developed in 5. The mean duration of therapy was 169 days. Due to therapy, there was stabilization of pulmonary and extrapulmonary tuberculosis with bacterial absence in the sputum and otic discharge of all the patients.