Objectives: The aim of this study was to investigate the influence of microclimate on the outcome of chronic secretory otitis media in children and to investigate whether microclimate has an impact on the outcome of chronic secretory otitis media in different surgical treatment methods. Patients and methods: 71 children with unilateral or bilateral chronic secretory otitis media were included in this study, so that a total of 130 ears were treated in this study. Ears were divided into two microclimatic groups using microclimatic factors that predominate in the area of residence of these children. The outcome of chronic secretory otitis media was compared with respect to the microclimatic group. The outcome was analyzed using tonal audiometry, the presence of effusion, and the presence of clinical sequelae: degree of pars flaccida retraction, myringosclerosis, retraction of the eardrum with malleus rotation, and scarring and perforation of the eardrum. Results: By comparing the outcome of chronic secretory otitis media in children with respect to given microclimatic factors, no statistically significant differences were obtained. Also, no statistically significant differences in the outcome of treatment by the selected surgical method between microclimatic groups were obtained. Conclusion: This study indicates that there are no significant differences in the outcome of chronic secretory otitis media between the compared microclimates and that in the compared microclimates there is no difference in the outcome with different treatment methods.