The aim of this research was to study the features of clinical and laboratory parameters of acute otitis media (AOM), taking into account the value of the leukocyte shift index (LSI) in pediatric patients with the demonstration of clinical cases. Methods and Results: This study included 100 children (55 boys and 45 girls) with AOM. The mean age of all patients was 4.32±0.31 years. Group 1 included 50 patients (30 boys and 20 girls) with acute suppurative otitis media (SupAOM) . Group 2 included 50 patients (25 boys and 25 girls)with acute serous otitis media (SerAOM). As a marker for determining the activity of the inflammatory process and the disorders of the immunological reactivity of the body, we chose LSI, calculated taking into account the parameters of the general blood test. Our results show the diagnostic significance of LSI in predicting the clinical course of AOM in patients in the age group of 2-16 years. The development of SerAOM is predicted when the LSI is 1.05±0.08; SupAOM - 2.08±0.23 The results obtained can be useful in providing specialized medical care for children of this age group, for optimizing the algorithms for preventive examinations and therapeutic interventions, and for offering the possibility of predicting the severity of the disease and timely treatment of SupAOM requiring a surgical intervention followed by systemic antibiotic therapy in order to prevent otogenic complications and hearing.