Background: Otitis media with effusion (OME) which also called glue ear is famous in children. Most of children under four years could have OME, but decline beyond six years of age, medical and surgical treatments are present for OME. Objective: The aim of the current work was to evaluate the impact of early extrusion of grommet tubes on the eustachian tubes of children and whether this necessitates another intervention or not. Subjects and methods This retrospective cohort study included a total of 191 pediatric patients (aged 3 to 14 years old) who suffered from bilateral otitis media with effusion (OME), not responding to medicinal treatment, and undergone myringotomy with Shepard grommet tubes insertion. It was performed at Department of Otorhinolaryngology, Faculty of Medicine, Benha University, Benha, Egypt. The included subjects were divided into two groups; Group (A) included 318 ears with standard extrusion time of grommets (6 to 12 months), Group (B) included 64 ears with early extrusion time (before 3 months from grommet tube insertion). Both groups were followed for 6 months after extrusion of the grommet's tubes. Results: At the insertion time the mean ages for group A and B were 5.3 years and 5.1 years, respectively, without statistical differences for age and sex. Adenoidectomy performed in 52.9 % of patients, without statistical difference between groups. Cure rate was 84.9% in group A and 84.4 % in group B, which was comparable. Conclusion: Early extrusion for grommets tube has similar fate to standard extrusion time. No further treatment in early extrusion time grommets until 6 months with treatment and follow up is elapsed.