Acute otitis media is diagnosed frequently in childhood with peak incidence between 6 and 15 months of age. It is the most common reason for physician visits and antibiotic prescriptions in children, with an excess of $100 spent per episode. In this article we discuss current concepts of complementary and alternative medicine as they apply to otitis media. A thorough literature review shows that, whereas many of these modalities are promising, few have been assessed with randomized controlled trials. Finally, we provide an algorithm that may be used in assessing and treating patients with acute otitis media.