Background: Acute otitis media (AOM) is a common bacterial disease in children, presenting with symptoms like otalgia, fever, anorexia, diarrhea and vomiting. AOM is often a self limiting condition, but is on many occasions treated with antibiotics. Guidelines on treating AOM are not internationalized, and European countries operate with separate national guidelines. Aim: The aim was to compare different national guidelines on treating AOM in Europe, and determine whether the Norwegian guideline is adequate for me, working as an intern at the emergency department in the future. The guidelines from Sweden, Denmark, Finland, Scotland, Great Britain, Holland, France, Germany and Italy were compared. Methods: Guidelines were sought for in Embase, PubMed, guidelines international network (GIN), and SveMed+. Results: Most guidelines had the same diagnostic criteria for AOM. The category of children who immediately should be treated with antibiotics varies between different European countries. There is, nevertheless, consensus that the youngest children should have antibiotics, while the older children are actively observed. Recommendation of the cases of AOM that should be followed up varies widely between the countries. Conclusion: The different national guidelines shared many similarities. The Norwegian guideline on how to treat AOM is in my opinion adequate, however, as a future intern I would prefer the guideline to be more specific and clarifying in some areas. Firstly it should contain guidance on what to do if diagnostic problems occur, as if the tympanic membrane is not fully visible. Secondly, the guideline could be more concrete about which cases that initially should be treated with antibiotics.