Chronic Pseudomonas ear infections are difficult to treat, particularly in immunodeficient patients. Vinegar therapy is a time-tested measure for the treatment of these infections. It is inexpensive, simple, easy to administer, and very effective. However, some physicians are reluctant to use it in immunocompromised patients or in the setting of a perforated tympanic membrane. We describe our successful use of vinegar therapy in a 32-year-old man with both of these conditions. His Pseudomonas ear infection had persisted for more than 5 years despite conventional drug treatment. Eventually, we treated him with instillations of topical vinegar, and his infection cleared in 3 weeks.