A review of the 20th century English-language literature has produced a total of 320 cases of tuberculous otitis media or otomastoiditis, of which a surprising 93 cases have been reported in the 5-year period 1986–1990. Eighty-three percent of these have come from indigenous African populations. The international health and sociological implications of this development are disturbing. Three personal cases seen during the past 8 years are presented, all of whom came from the indigenous Norwegian population. The epidemiology of these cases is therefore different, which can result in a diagnostic delay due to a low index of suspicion. The historically classical signs of this disease are frequently absen