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No sponsorships or competing interests have been disclosed for this article. Objective. (1) Analyze otologic procedural malpractice litiga-tion in the United States of America. (2) Discuss ways to prevent future malpractice litigation. Study Design and Setting. Case series with record review. Methods. The study is a case series with review of court records pertaining to otologic procedures using the Westlaw legal database. The phrase medical malpractice was searched with terms related to otology and neurotology obtained from the AAO-HNS website. Results. Of the 47 claims that met inclusion criteria, 63.8% were decided in the physician’s favor, 25.5 % were decided in the plaintiff ’s favor (average payment $446,697), and 10.6 % were settled out of court (average paymen