Background: Acute suppurative otitis media (ASOM) is one of the most common otorhinolaryngological childhood infections globally, associated with prescription of antimicrobial agents even against a background of increasing bacterial resistance to antibiotics. Aim: This study is aimed at evaluating the microbial isolates of ASOM in children, attending Usmanu Danfodiyo University Teaching Hospital, Sokoto, North-western Nigeria. Materials and Methods: A cross-sectional study design was used to investigate 58 patients who met the inclusion criteria. Methods of data collection were interviewer administered questionnaire, clinical examination, and laboratory investigation. Quantitative variables were summarized using mean and standard deviations, while qualitative variables were summarized using frequencies and percentages. Results: The proportion of sterile cultures was 3.3%, while the remaining showed different species of aerobes (96.7%), anaerobes (1.6%) and fungi (4.9%). Ratio of gram-positive to gram-negative aerobic bacteria was 3.5: 1.The gram-positive aerobes isolated were Streptococcus pneumonia (37.7%), Streptococcus pyogenes (14.8%) and Staphylococcus aureus (23.0%); while Moraxella catarrhalis (11.5%) was the main gram-negative aerobe. Bacteroides fragilis (1.6%) was the only anaerobe, while Aspergillus niger (3.3%) was among the fungi isolated. Amoxicillin/clavulanic acid showed 100.0% sensitivity; followed directly by erythromycin (91.5%). Conclusion: This study showed that ASOM is more likely a mono-aerobic infection than polymicrobial with high sensitivity to amoxicillin/clavulanic acid. Its treatment should include among others, early commencement of antibiotics with good gram-positive and gram-negative aerobic coverage.