Introduction: Otitis media with effusion (OME) is the most common cause of acquired hearing loss in children. Conventional medical therapy has been tried for OME including antibiotics, decongestants, antihistamines, local and systemic steroids. The results of these trials are quite controversial. Intranasal mometasone furate is a powerful anti-inflammatory that has been thought to benefit in the treatment of OME. Objective: To evaluate the possible role of mometasone furate in the treatment of children with OME. Patients and methods: Sixty children having OME with significant hearing loss were included in the study. They were divided into two groups (A & B) each composed of 30 children. Patients in group A were given intranasal mometasone furate 100mcg/day, 1 puff in each nostril for 6 weeks. Patients in group B were subjected to watchful waiting without any medication for the same period. Clinical and audiological follow up was done after 6 weeks. Results: The overall results showed that there is no significant difference in improvement of OME between the 2 groups. Conclusions: Administration of intranasal mometasone furate for children with OME is not superior to watchful waiting.