Tuberculosis of the middle ear and mastoid in adult usually has an insidious painless onset and proceeds on a chronic course. Tuberculous involvement of the tympanic membrane leads to early perforation and aural discharge before sufficient accumulation of purulent exudate to cause pain. The presence of multiple perforation of the tympanic membrane or exuberant granulation tissue in the middle ear is suggestive of tuberculous infection. But many patients with primary tuberculous otitis madia are subjected to surgery without a correct etiological diagnosis having been made. Recently, we experienced three cases of pathologically confirmed primary tuberculous otitis media without pulmonary involvement, so we report these cases with review of literature.