Introduction: Secretory Otitis Media (SOM) is the commonest clinical condition that can cause conductive deafness, especially among school going children. The outcome of hearing loss in children, include, speech problems, behavioral problems, and poor academic performance. Management of SOM therefore remains crucial. Here, comparative study between antibiotics Vs surgical therapy in treatment of SOM has been done. Materials and Methods: The study was started with enrolling fifty patients. A detailed history with ENT examinations was done and documented in a validated proforma. Routine investigations like CBC, urine examination, audiological investigation like impedance audiometry etc., was done in all cases. Observation and results: About 70% of the patients presented with symptoms of ear block with mouth breathing. Increased incidence was found in the 2-6 years of age group. The study shows that, surgery can fasten the rate of recovery, shorten the duration of therapy, and prevent the recurrence of SOM as compared to treatment with antibiotics. Conclusion: However, both the treatments have complications associated with them. Large, well-controlled studies could help resolve the risk benefit ratio by measuring SOM recurrence, functional outcome, quality of life and long term outcomes.