Background: Otomycosis is one of the most common conditions encountered in a general otolaryngology clinic setting. It represents about 10% of all cases of otitis externa. It is often seen between the second and third decades of life. Objective: To compare between topical Clotrimazole and Povidone Iodine in treatment of otomycosis. Patients and Methods: This is a randomized controlled clinical trial study included 100 patients clinically diagnosed as otomycosis with positive mycological culture. This study conducted at the otolaryngology outpatient clinic of Al-Hussein University Hospital and Al-Mataria Teaching Hospital between May 2019 and October 2020 after approval by the Research Ethics Committee of faculty of medicine Al-Azhar University. Results: This study showed that 48 patients (21 patients from Povidone Iodine group and 27 patients from Clotrimazole group) gave a history of habitual ear self-cleaning or manipulation from total 100 patients, so it is the most common predisposing factor of otomycosis in patients involved in this study. Abuse of antibiotic eardrops as the only predisposing factor was the second predisposing factor for otomycosis, as 18 patients (12 patients from Povidone Iodine group and 6 patients from Clotrimazole group) from total 100 patients gave a history of using antibiotic eardrops for long periods. Other predisposing factors were using earpiece in an unhygienic manner reported in 12 patients, diabetic mellitus as the only predisposing factor reported in 11 patients, diabetes mellitus with antibiotic eardrops abuse reported in 2 patients and swimming reported only in 1 patient. Conclusion: From this study it can be concluded that there is no statistically difference between Povidone Iodine and Clotrimazole in treatment of otomycosis. Our findings reinforce the use of povidone iodine in otomycosis treatment because it is cheap, available, with no documented resistance thus far and no toxic effects on inner ear in case of perforated tympanic membrane.