Acute otitis media (AOM) is a widespread disease which may lead to extra- and intracranial complications. Intracranial complications of AOM are currently still potentially health and life threatening even with proper treatment. Otitic hydrocephalus is a rare intracranial complication of otitis media. It is characterized by elevated cerebrospinal fluid (CSF) pressure with normal CSF biochemistry and without any focal neurologic abnormality other than those related to the increased intracranial pressure. The precise mechanism underlying the development of otitic hydrocephalus is unknown. Eradication of ear disease and lowering of the elevated intracranial pressure are the goals of the therapy. The authors of this essay will introduce a 7 years old boy with otitic hydrocephalus and review the literature. It can be concluded that, in patients with acute or chronic ear infections, complaints of headache, blurred vision, diplopia, or photophobia may be a heralding sign of an intracranial complication. On the other hand, MRI is very important for detection of the complications of otitis media. Contrast-enhanced MRI and magnetic resonance venography must be immediately performed in patients with neurological symptoms such as nerve palsy, neck stiffness, or confusion.