Background: Otalgia is a very common symptom induced by a wide variety of diseases. Depending on the location of the pathology, otalgia is categorized into primary and secondary types. In primary otalgia, the main source of the pain is located within the ear. On the contrary, secondary or referred otalgia is defined as a disorder which the underlying pathology is outside of the ear complex giving rise to the sensation of pain in the ear. Multiple etiologies have been reported to produce secondary otalgia including temporomandibular joint dysfunctions, cervical spine pathologies, laryngitis, pharyngitis and tonsillitis. Case Presentation: In this study, we present a 57-year-old man with referred otalgia, associated to rotator cuff tendon tear and acromioclavicular joint osteoarthritis, which is uncommon and atypical. Conclusion: Shoulder pathologies like rotator cuff tendon tear and acromioclavicular joint osteoarthritis can be considered as a possible but rare cause of referred otalgia