The general practice records of 68 children with secretory otitis media (SOM) were studied. A control group was matched one-for-one on the basis of sex, year of birth and general practice list. The SOM group had twice the incidence of recorded atopy, twice the incidence of recorded previous upper respiratory tract infections (URTI), and three times the incidence of recorded attacks of acute otitis media (AOM) compared with the control group. The recorded antibiotic treatment of URTI and AOM in the two groups was similar. Antihistamines and decongestants were seldom recorded in the treatment of AOM. The higher incidence of atopy found in the children with SOM prompts the suggestion that antihistamines and decongestants used by general practitioners in the routine treatment of AOM and URTI might help prevent the development of SOM. A prospective double-blind trial along these lines seems desirable.