Introduction: Otalgia is defined as ear pain, it is one of the most common complaints with which a patient presents to ENT OPD or emergency department Aims and Objectives: To identify causes of otalgia in the ear and non-ear diseases in patients visiting the ENT OPD of Saveetha Medical College and Hospital in Tamilnadu, India. Methodology: The study was conducted on 40 patients who visited the ENT OPD of Saveetha Medical College and Hospital with an earache. Patient__ampersandsignrsquo;s details such as age, sex, complaint, causes and physical finding were recorded in an excel sheet and. The study tools used in the study are clinical examination and investigations. Result: The leading cause of otalgia was found to be non-ear diseases (60%) from the study done on 40 patients with an earache in the ENT OPD of Saveetha Medical College and Hospital. Dental pain was the leading cause and was to be the cause in males predominantly over females by three times. Otitis externa was the leading cause of ear diseases followed by acute otitis media, chronic suppurative otitis media and by impacted wax. Conclusion: Since the last century there have been many studies to show the non-ear causes of otalgia which is caused by referred pain from other sites which are connected with the ear by different nerves, Since classifying the cases of otalgia as those caused by ear and non-ear-diseases will help in the assessment and treatment of the pain.