Otitis media/interna is well-described in laboratory rats, but there is limited information on treatment and prognosis in pet rats. The objective of this retrospective study was to describe the diagnostic methods, treatment options, and survival associated with otitis media/interna in companion rats (Rattus norvegicus). Medical records were reviewed to gather information regarding signalment, clinical signs, diagnostic imaging, microbiology, necropsy, treatment, and survival in pet rats diagnosed with otitis media/interna via imaging, necropsy, or both. Nine rats met the inclusion criteria from one institution (2011-2024); additional cases are pending from other institutions. Rats were diagnosed via necropsy (n=5), computed tomography (n=3), or tympanic bullae ultrasound (n=1). Seven rats had clinical signs, including head tilt, ataxia, and paresis, while two rats were incidentally diagnosed via imaging. Four rats had intracranial disease, such as meningoencephalitis or rhombencephalitis. Five rats had concurrent respiratory disease. Bacterial culture was performed in n=5 and revealed various bacteria, including Staphylococcus aureus. Mycoplasma was identified in n=3 (n=2 via PCR of the lungs at necropsy, n=1 via next-generation sequencing of the purulent aural discharge). Treatments included antibiotics (n=6), corticosteroids (n=3), and myringotomy (n=2). Survival times were 0 days in n=3 (died or euthanized on day of presentation); 8, 12, 22, and 128 days in treated, clinically affected rats; and 106 and 261 days in rats diagnosed incidentally via imaging. Otitis media/interna can be associated with intracranial invasion in pet rats. Clinical cases may have short survival times, while cases diagnosed incidentally via imaging likely have a better prognosis.