Patients, parents, and physicians are all concerned about the risks of swimming unprotected with middle ear ventilation tubes. The risks have not previously been carefully quantified or correlated with the degree of swimming activity. In this study, 53 children with tympanometrically proven patent long-shafted tubes were allowed to swim unprotected. They suffered six middle ear infections that were clearly caused by swimming. Five of these infections occurred in divers. The rate of infections for divers was approximately one per 100 days of swimming activity. The rate for non-divers was approximately one per 600 days. Unprotected swimming was well accepted by almost all parents and patients. The need for earplugs for all children who swim with long-shafted ventilation tubes is questioned.