OBJECTIVE To find out the prevalence and etiologies of middle ear disease among deaf children in a school for the deaf. METHODS A total of 162 students with hearing impairment attending a school for the deaf during the school year of 2001-2002 were admitted to this study. The range of age was from 6 to 20 years. The examination consisted of inspection of the auricle and external auditory canal, and otoscopic, audiometric and tympanometric evaluation. School performance was assessed using the results of end-of-year school examination and continuous assessments obtained from the school administration. RESULTS The demographic properties of the study group revealed that 81 (60.9%) of children were male and 52 (39.09%) were female. Most of the children (45%) were in the group of 9-13 years of age. On pure tone audiometric evaluation, sensorineural hearing loss (HL) was found in 99 (85.3%) and mixed type HL in 17 (14.6%) of 116 cases. Impacted wax was the most common pathology and was seen in 15 (39.4%) of children. Middle ear diseases were detected in 38 (28.5%) of children with otoscopic examination. CONCLUSION This study shows that hearing impairment and preventable ear diseases are important health problems among the school children for the deaf. It is essential to start the school education early in time and to start using hearing aid before 2.5 year of age.