Chronic suppurative otitis media is persistent and insidious disease that often lead to destructive changes and irreversible sequelae if not treated properly. The study aimed to find the pattern of antimicrobial drug susceptibility of the pathogenic microorganisms causing tubotympanic type of CSOM. The study was conducted in 65 patients with tubotympanic type of disease attending the (ENT) OPD clinic at Central Hospital-Tripoli, Libya. Drug susceptibility testing was carried out using a Kirby Bauer disc diffusion method. Pathogens were isolated from 96.9% patients with a total of 95, of the 95 isolates, (88.4%) were bacterial pathogen and (11.6%) were fungal. The most predominant isolates were Pseudomonas aeruginosa (31.6%), followed by Staphylococcus aureus (25.3%) and Proteus mirabilis (8.4%). The antimicrobial profile of the major isolates of Pseudomonas aeruginosa revealed maximum sensitivity to ciprofloxacin (93.3%), followed by polymyxin (90.0%), ceftazidime (83.3%) and amikacin (73.3%). Whereas the antimicrobial profile of the isolates Staphylococcus aureus was revealed maximum sensitivity to ciprofloxacin (95.8%), followed by amoxil/clavulanic acid (83.3%), cephalexin, gentamicin, chloramphenicol (79.2%) each, neomycin (75.0%) and erythromycin (70.8%). On the other hand Proteus mirabilis showed high level of sensitivity to ciprofloxacin, ceftazidime (100%) each, followed by amoxil/clavulanic acid, amikacin (87.5%) each, gentamicin, neomycin, trimethoprim sulphamethoxazole (75.0%) each. Our finding highlight the importance of a continuous and periodic evaluation of microbial pathogens causing tubothympanic CSOM and their susceptibility patterns to antimicrobial drugs, this will guide the clinician for choosing the appropriate treatment regimen and prevention of the emergence of resistant strain as well as can minimize complication that require surgery.