We conducted a prospective study of 24 patients to evaluate the evolution of intracranial complications resulting from otogenic infection and to correlate the course of the disease with surgical treatment. Almost half of the patients were younger than 18 years, and most were male. The most common intracranial complication was brain abscess, followed by meningitis, lateral sinus thrombosis, and extradural abscess. Cholesteatoma was found in 14 patients. After the complications were confirmed by computed tomography, initial treatment consisted of intravenous systemic antibiotics followed by mastoid surgery. The surgical approach was determined by the type of ear disease, not by the type of neurologic complication. Modified radical mastoidectomy was performed in 16 patients, tympanomastoidectomy in 6, and myringotomy in 2. No significant morbidity, mortality, recurrence, or residual neurologic deficit was observed at the 6-month follow-up. Early surgical intervention is important in achieving positive outcomes in patients with such intracranial complications.