Patients with discharging ears usually present to the general practitioner (GP). There are several causes ranging from otitis externa, acute suppurative otitis media (ASOM) to chronic suppurative otitis media (CSOM). Successful management of these patients depends upon an accurate assessment of the ear, but this is hindered by debris and pus in the ear canal obscuring the tympanic membrane. An accurate history, careful aural cleaning and examination can help make an accurate diagnosis. This article aims to assist the GP in identifying CSOM, some forms of which have the potential to cause serious complications.