Background: Otitis media with effusion (OME) is the most frequent indication for surgery in children. Some surgeons prefer to use adenoidectomy and myringotomy with tympanostomy tubes insertion to prevent the sequelae of the disease and also more improvement of hearing. The aim of this study is to compare adenoidectomy-myringotomy with adenoidectomy-myringotomy plus tympanostomy tube in the management of OME. Methods: Thirty children with OME (age range 4-8 year) were randomly assigned to receive adenoidectomy with myringotomy in one ear or adenoidectomy, myringotomy plus tympanostomy tube insertion in the other. The patients were subjected to auditory examinations 1 and 6 months post operation to evaluate hearing levels. Results: The results showed no significant difference in hearing level improvement between these two methods of surgery. Conclusion: It is concluded that adenoidectomy with myringotomy is sufficient for management of otitis media with effusion in children in short term.