The head area has a rich sensory innervation designed to protect one of the most important human organs, the brain. Headache is one of the main reasons for seeking medical help. Patients often turn to an otorhinolaryngologist on their own or in the direction of other doctors. Pain syndrome in the head area is usually characterized by a polymorphic clinical picture, characterized by polyethology, multifactorial nature and objective complexity in determining the etiological factors of its occurrence. Otalgia is a special case of headache or cephalgia. The purpose of this work was to highlight the problem of otalgia of unknown genesis. The classification of otalgia is considered. A brief review of the literature is given. Primary otalgia occurs as a result of a pathological condition of the ear and examination of the ear, as a rule, allows you to determine the cause. Secondary otalgia is diagnosed when the source of pain is not localized directly in the ear and an examination of the ear during otoscopy does not reveal an obvious pathology. Otalgia of unclear etiology is a collective term based on a common symptom – ear pain, but with a different etiology. Among the etiological factors, three large groups of causes can be distinguished. The first is an implicit, atypical pathology of the ear. The second is dental pathology, primarily of the temporomandibular joint (Kosten’s syndrome). The third most common group of causes is neurological pathology (neuralgia, osteochondrosis of the cervical spine, migraine). An algorithm for the actions of an otorhinolaryngologist in the diagnosis of “otalgia of unknown etiology” has been created. The results of their own developments are presented. It has been established that this problem is typical for older age groups (over 30 years old). In terms of gender, women predominate (more than 2 times). In addition to an otorhinolaryngologist, a dentist, a neurologist, and sometimes a psychiatrist, it is necessary to participate in the diagnosis and treatment of the nosology under discussion.