Background: Otitis media is a common childhood disease. Adults′ involvement though uncommon, is a common cause of recurrent otorrhoea and hearing loss of infective origin in adults. This study determines the pattern of adult suppurative otitis media in a tertiary health institution, in North western Nigeria. Materials and Methods: This is a retrospective five years study of 72 patients with suppurative otitis media in patient 16 aged years and above, who presented to ENT clinic in a tertiary institution, North western Nigeria from January 2006- December 20011. Results: A total number of 112 patients were diagnosed with suppurative otitis media, out of which 72 case files were accessible for review. The age range was 16-65 years with the mean of 31.2 (SD - 13.1). Most proportion (41.7%) of patients were between the age of 16-25 years Fifty five (76.4%) patients had chronic suppurative otitis media, of which 13 (18.1%) were bilateral, 30 (417%) had pre-existing childhood recurrent otorrhoea while acute suppurative otitis media accounted for 23.6%. Sinusitis (72.7%) and ear trauma (15.2%) were the predisposing risk factors in chronic and acute suppurative otitis media, respectively. Pseudomonas aeruginosa (44%) and staphylococcus aureus (12%) were isolated in chronic and acute suppurative otitis media, respectively. Conclusion: Adult suppurative otitis media was mainly of the chronic variety and sinusitis and pre-existing childhood recurrent otorrhoea were observed in these patients.