Otitis media with effusion is one of the most common causes of hearing impairment in childhood. This study is a retrospective study of 175 patients complaining of otitis media with effusion OME. Patients were divided into two groups: group1 were patients with adenoid enlargement while group2 were patients without adenoid enlargement. The data concerning management and follow up were gathered and statistically analyzed.It was concluded that adenoidectomy with or without tube insertion is the most effective treatment for patients of group1 while, patients of group2 are mostly responding to medical treatment.