Background: Otomycosis is a superficial mycotic infection of the external auditory canal that is caused by opportunistic fungi. It is common fungal infection of the ear that is worldwide in distribution. It presents with nonspecific symptoms of itching, earache, ear discharge, hearing loss, aural fullness and tinnitus. Aim: to detect the potassium hydroxide (KOH) mount positive in ear discharge of chronic otitis media and treat these patients. Material and Methods: This retrospective study conducted in the Department of ENT, Darbhanga Medical College & Hospital, Darbhanga, Bihar, India for 1 year. Total 200 Patients chronic otitis media were included with no history using ear drops for last one week and using two sterile swab without touching the external auditory canal, ear discharge was taken from middle ear and placed in sterile container and sent for microbiology laboratory for culture and potassium hydroxide (KOH) mount respectively. Results: Most of the patients from 20-30 years 69 (34.5%) and followed by 30-40 years 59 (29.5%). Females 115(57.5%). were found to be more common than males 85(42.5%). Overall prevalence rate KOH positivity was found to be 20.5%. Our study showed that among 200 patients of either sex between age group 9 months to 62 years diagnosed with COM, 41 (20.5%) patients showed KOH positivity which is clinically and statistically found to be significant and probability of KOH positive in future will be in between 9.2-22.6%. Most common fungal pathogen was found to be Aspergillus 26 (63.41%), and followed by Candida species 11(26.83%), other saprophytes 4(9.76%). Conclusion: We conclude that in patients with COM, send ear discharge for both culture and sensitivity and KOH mount and it should be routine and always consider combined therapy i.e., antibiotic and antifungal drugs.