Complications of acute otitis media (AOM) are not uncommon in adults, however complications in the form of Horner’s syndrome have only been described a few times before. In this case we present a patient with Horner’s syndrome presenting as a complication of AOM in an otherwise unaffected patient. The patient was feeling well overall and was only bothered by an earache and a hanging left eyelid. Clinical examination did not reveal any other findings than left-sided AOM with spontaneous perforation of the tympanic membrane, miosis and ptosis. The patient did, however, also describe anhidrosis on the left side of the face. The patient was admitted for IV antibiotic treatment for 24 h, and followed afterwards in the out-patient clinic until complete remission at 9 months. Horner’s syndrome is a rare complication of AOM and can occur as an isolated complication.