OBJECTIVE: Acute otitis media (AOM), a common middle ear infection, can lead to severe complications if not properly managed. The coronavirus disease 2019 (COVID-19) pandemic significantly impacted healthcare delivery and disease management. This study aimed to evaluate the incidence of complicated AOM cases from the pre-pandemic to post-pandemic period. METHODS: A retrospective review was conducted at Necmettin Erbakan University, Department of Otolaryngology, on patients diagnosed with complicated AOM in the period from January 2014 to February 2024. Patients were categorized into three periods: pre-pandemic (2014-2020), pandemic (2020-2022), and post-pandemic (2023-2024). Clinical data, including demographics, types of AOM complications, and treatment methods, were analyzed. RESULTS: A total of 32 patients (20 females and 12 males) with AOM complications were identified. Mastoiditis was the most common complication, seen in 43.75% of the patients, with increased incidences of 64.3% in the post-pandemic period. Subperiosteal abscess was noted in 12.5 % of the patients, exclusively in the pandemic and post-pandemic periods. Facial nerve paralysis (12.5%) and labyrinthitis (9.3%) were noted only in the post-pandemic period. Meningitis was noted in 15.6% of the patients, with increased incidences in the post-pandemic period. Observed during the post-pandemic period, sigmoid sinus thrombosis was noted in only one patient (3.1%). CONCLUSION: Despite the reduced AOM incidence rates during the early pandemic, a surge was seen in complicated AOM cases in the post-pandemic period. This increase could be linked to COVID-19’s impact on the immune system, pathogen virulence changes, and disruptions in vaccination protocols. These findings highlight the need for improved surveillance of AOM cases regarding complications in the post-pandemic era.