There is availability of number of higher antibiotics, still there is challenge to treat middle ear infection and so its recurrence mostly occurs. Sushrut has already described the treatment of Karnastrava, Putikarna and Krimikarna.2Today every persons lifestyle is changed with food habbit, working hours, type of work & pollution etc., these factors are responsible forupper respiratory tract infections which leads to otitis media ( Karnastrava)1. Sushrut has described the treatment for Karnastrava is guggule dhupan 4. As the guggule is ‘ushna’ acts ‘vatshamak,’ due to ‘tikshna, ushna gun, kaph shamak5. Guggule is also shothhar, Jantughna, Vranashodhan, vranaropan and vednasthapan5, it is used in kaph wat rog’. Dhup of guggule can easily reaches at affected area. This properties of guggule is useful in the management karnastrava.So, here I present a case where a chronic otitis media (KARNASTRAVA) is treated with’ guggule dhup.’