OBJECTIVE To explore the different and common features between adults and children with otitis media with effusion (OME) on course of disease, clinical characteristics and audiometric changes. METHOD Pure tone audiometry, tympanogram and clinical information were analyzed and compared between 34 cases of adults and 42 cases of children with OME. RESULT The course of disease was relatively short in children. The adenoid vegetation inflammation was more frequently found in children, while the OME occurred more often in adults. The air conduction and bone conduction threshold increased both in children and adults, particularly at high frequencies of 2 and 4 kHz. The bone conduction threshold at 4 kHz in adults was significantly higher than that in children (P < 0.05). In the cases with C type tympanogram, the negative pressure in adults was even lower than that in children (P < 0.05). CONCLUSION The OME in children is often relatively shorter in course of disease, which is mainly caused by adenoid vegetation. Sensorineural deafness can occur both in children and adults, especially at high frequencies. OME in children is less severe, however, it may lead to negative effects in learning and cognition, which should be diagnosed and managed in time.