Intratympanic drug delivery is a commonly used method for administering topical drugs in otology. It involves directly delivering drugs into the middle ear, allowing them to diffuse to the inner ear through the round window membrane or oval window. This method is employed to achieve therapeutic or diagnostic effects. In recent years, intratympanic drug delivery has become widely utilized in the diagnosis and treatment of various otological diseases including sudden sensorineural hearing loss, Meniere’s disease, secretory otitis media, and autoimmune inner ear diseases. However, there is currently no standardized protocol regarding the operation specifications, indications, timing of administration, and treatment plans for intratympanic drug delivery. In order to promote the standardization of intratympanic drug delivery, we have assembled a group of experienced and accomplished young and middle-aged domestic experts who possess extensive experience and notable achievements and formulated the clinical practice guidelines for intratympanic drug delivery based on clinical expertise and evidence-based medical researches. The guidelines primarily focus on four aspects of intratympanic drug delivery: glucocorticoids, gentamicin, intratympanic injection of contrast media, and other drugs. It provides a comprehensive and systematic summary of these aspects, with the goal of guiding and standardizing the clinical application of intratympanic drug delivery technology.