Background: Individuals with DS rank lower in their balance performance when compared to the general population or other mentally handicapped individuals (Felicioli and Moretti, 2002). During an episode of otitis media the child's balance deteriorates and the child may become clumsy and fall more often (Casselbrant et al., 2008). This could lead to impairment in their lifestyle and endangers their life (Tsimaras and Fotiadou, 2004).Objective And Methods: This study included 30 Down syndrome patients who was divided into 3 groups according to the tympanogram results. Group (A): 13 DS subjects with bilateral normal middle ear pressure. Group (B): 12 DS subjects with bilateral abnormal middle ear pressure. Group (C): 5 DS subjects with unilateral abnormal middle ear pressure. The aim was to compare balance performance between the 3 groups using sensory organization test (SOT) of computerized dynamic posturography (CDP).Results: In our study we found no statistical significant difference in composite score and sensory analysis between the three studied groups. On the other hand, when compared to normal children we found statistically significant decrease in composite score for DS children compared to normal children.Conclusion: Middle ear effusion by itself is not a leading factor affecting balance in DS children. On the other hand, Postural control is affected in most of the DS children when compared to normal children.