Otitis media with effusion (OME) is one of the most frequent childhood diseases and the most common cause of hearing loss in childhood. Eighty percent of all children have an episode of OME by the age of 10 years, typically by the age of 3 years. The disease is characterized by an accumulation of fluid in the middle ear behind an intact tympanic membrane in the absence of signs and symptoms of acute infection. This causes progressive conductive hearing loss, which is the main symptom of the disease. When left untreated, OME may lead to the development of adhesive otitis media, tympanic membrane abnormalities, tympanic sclerosis, cholesterol granuloma, or acquired primary cholesteatoma The etiology of OME is multifactorial. Allergy is considered an important etiological mechanism of OME. An association between allergy, proinflammatory and immunoregulatory cytokines, obesity, a high-fat diet, and OME is discussed in this paper.