Secretery otitis media was treated by several methods, including ventilation and drainage using ventilating tubes, but is occasionally underwent relapse, and showed chronicity and other complications. So in the view of the etiology and the course of the treatment of secretory otitis media, we studied the relationship between secretory otitis media and upper respiratory tract infections such as paranasal sinusitis and adenoid hypertrophy. 254 cases of children under 10 years old who had paranasal sinusitis, adenoid hypertrophy and secretory otitis media were classified into 3 groups : a group having only one of the above disease, or a group having two of the above diseases, or a group having all of the above diseases, and each group was compared against each other. As result, among the 78 cases of secretory otitis media the highest was sercretory otitis media combined with paranasal sinusitis, and then secretory otitis media plus adenoid hypertrophy and paranasal sinusitis plus adenoid hypertrophy in that order. Secretory otitis media alone showed only in a few cases. In conclusion, the study of the above 3 groups revealed that paranasal sinusitis and adenoid hypertrophy had considerable relationship with secretory otitis media.