Objective To explore the effect of intratympanic injection of dexamethasone combined with ambroxol hydrochloride in the treatment of secretory otitis media, and to provide reference for clinic. Methods Eighty patients with secretory otitis media were admitted to Yancheng Third People's Hospital from January 2020 to March 2023 were selected as the study objects, and were divided into control group and observation group according to random number table method, with 40 cases in each group. Both groups of patients underwent tympanic membrane puncture and ?uid extraction. The control group was treated with intratympanic injection of dexamethasone, while the observation group was treated with intratympanic injection of dexamethasone combined with ambroxol hydrochloride. The levels of different frequency airway hearing, in?ammatory factors in middle ear effusion, occurrence and recurrence of adverse reactions were compared between the two groups. Results After treatment, the threshold levels of air conduction at 0.5 kHz, 1.0 kHz, and 2.0 kHz in both groups of patients were lower than those before treatment, and the levels of the indices above of the observation group was signi?cantly lower than those in the control group (P<0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α), interleukin-5 (IL-5), and interleukin-8 (IL-8) in both groups were lower than before treatment, and the levels of the indices above of the observation group was lower than those in the control group (P<0.05). There was no statistically signi?cant difference in the total incidence rate of adverse reactions between the two groups of patients (P>0.05). The recurrence rate of patients in the observation group was lower than that of the control group (P<0.05). Conclusion Intratympanical injection of dexamethasone combined with ambroxol hydrochloride is effective in the treatment of secretory otitis media patients, which can improve hearing levels, reduce the level of in?ammatory factors, have good safety, and can reduce recurrence rate.