Chronic Otitis Media (COM) represents a significant clinical challenge in otolaryngology, characterized by persistent middle ear infection and lasting alterations to the tympanic membrane. This review article delves into the complex nature of COM, exploring its classification, pathogenesis, etiology, and management strategies. COM is classified based on disease activity and mucosal involvement into inactive and active types, each with unique clinical and pathological features. The pathogenesis of COM is a multifactorial process, primarily driven by Eustachian tube dysfunction, recurrent infections, and inflammatory responses. Etiologically, COM can be traced back to unresolved acute otitis media episodes or chronic tympanic membrane retractions, leading to conditions such as cholesteatoma. Management strategies are tailored to the disease's severity and type, ranging from conservative measures to surgical interventions aimed at infection eradication, tympanic membrane repair, and hearing restoration. This review highlights the necessity for a personalized treatment approach, considering the diverse manifestations and underlying causes of COM. The insights provided offer a comprehensive perspective on COM, aiming to enhance clinical outcomes and patient quality of life through informed diagnosis and targeted treatment strategies