Otitis externa (OE), or swimmer's ear, is a common inflammatory condition affecting the external auditory canal, leading to symptoms such as ear pain, itching, and hearing impairment. It is caused by various pathogens, including Pseudomonas aeruginosa and Staphylococcus aureus. Treatment typically involves antibiotics, analgesics, and aural packing. To compare the clinical effectiveness of antibiotic-steroid ointment wicks versus antibiotic-steroid drops-soaked gel foam in pain management for patients with otitis externa. A prospective study was conducted at Aarupadai Veedu Medical College and Hospital from September 2022 to September 2023. One hundred patients, aged 18-60 years, with acute otitis externa, were randomly assigned to two groups: Group A received antibiotic-steroid ointment wicks, and Group B received antibiotic-steroid drops-soaked gel foam. Pain levels were assessed using the Wong-Baker Pain Assessment Scale, Visual Analog Scale, and Numerical Rating Scale on Days 1, 3, and 5. Statistical analysis was performed using SPSS software, with significance set at p <
0.05. Group A experienced a significant reduction in pain compared to Group B. On Day 1, there was no significant difference in pain scores between the groups (p = 0.728). However, on Day 3 and Day 5, Group A reported significantly lower pain levels than Group B (Day 3: p = 0.001*, Day 5: p = 0.001*). Within-group analysis revealed substantial pain reduction over time in both groups, with the most pronounced decrease observed in Group A. Group A's pain scores decreased from 6.36 on Day 1 to 0.08 on Day 5, while Group B's scores decreased from 5.70 on Day 1 to 2.84 on Day 5. The study demonstrates that antibiotic-steroid ointment wicks are more effective than antibiotic-steroid drops-soaked gel foam in reducing pain associated with acute otitis externa. While both treatments significantly alleviated pain over time, the ointment wick showed superior efficacy, making it a preferred option for managing this condition.