Objective: To summarize and analyze the clinical characteristics of otogenic brain abscess and explore the treatment strategy. Methods: The clinical manifestations, auxiliary examination, treatment and follow-up of patients diagnosed with otogenic brain abscess admitted to the People"s Hospital of Xinjiang Uygur Autonomous Region from January 2007 to December 2023 were retrospectively analyzed. Results: All 24 patients had a history of otitis media, 17 patients had headache symptoms, all of them completed head CT, 19 of them completed head MRI; There were 16 cases of temporal lobe abscess, 6 cases of cerebellar abscess, and 2 cases of both. In 12 cases, the brain abscess was excised or drained first, and then transferred to otorhinolaryngology department for middle ear mastoidectomy. 5 cases underwent radical mastoidectomy first, and resection or drainage of brain abscess in the second stage. One case was treated conservatively. After 6-24 months of follow-up, 20 patients were cured, 2 patients died, and 2 patients were lost to follow-up. Conclusion: Otogenic brain abscess usually occurs in cholesteatoma of the middle ear. Brain abscess should be excluded when headache and CT of temporal bone indicate bone destruction in the middle and rear cranial fossus. For its treatment, adequate amount and full course of sensitive antibacterial drugs should be given as soon as possible, and appropriate surgical methods should be selected according to the location, size, whether the abscess is involved in functional areas, the patient"s immune status, age, and systemic conditions, so as to allow the patient to obtain more benefits.