Ghadersohi S, et al. - This study entailed the elucidation of the management strategies for cholesteatoma diagnosis, surgical treatment, and post-operative management in children with Down syndrome. A connection was unveiled between the diagnosis of cholesteatoma in Down syndrome with otorrhea, hearing loss, and CT scan findings of ossicular erosion and mastoid sclerosis. Management of maximum cases was through canal wall up (CWU) surgical approaches. It was noted that the use of hearing aid was common post-operatively.