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Otitis externa (OE) is an acute, painful inflammatory condition of the external auditory canal that affects all age groups and accounts for about half of all patients presenting with ear pain. Common causes are gram-negative bacteria, Staphylococcus aureus, fungi, and dermatologic conditions such as eczema, seborrhea, and psoriasis. Risk increases with prolonged exposure to heat and moisture, especially in those who swim frequently or live in a tropical climate. Treatment involves cleaning the canal thoroughly and instilling ototopical broad-spectrum antibiotics. Although OE is relatively benign and easy to treat in the primary care setting, it can have life-threatening complications, especially in diabetic and immunocompromised patients. This article reviews the differential diagnosis, outlines treatment, and discusses preventive measures. A patient-education sheet is provided.