Objectives <p>There is conflicting information on the rates of cholesteatoma in the adult population in relation to socioeconomic deprivation and limited studies focusing on the relationship with paediatric cholesteatomas. The rate of paediatric cholesteatomas is not well known. In this study, we aim to take an in-depth look into the rate and severity of cholesteatoma in children across different socioeconomic backgrounds in the Greater Glasgow and Clyde area.</p> Methods <p>The case history of each child who had mastoid surgery at the Royal Hospital for Children between 2015 and 2021 was studied in-depth to look at the presence and severity of cholesteatoma. This was then compared to their socioeconomic score (SIMD) based on their postcode. Statistical tests were performed to see if there was a correlation between the two.</p> Results <p>Out of 306 patients who had mastoid surgery, 145 met our inclusion criteria. We found no statistical difference between the rate of cholesteatoma and socioeconomic background. There was no statistically significant difference between the age at presentation and different stages of cholesteatoma. However, there was a correlation between those of low socioeconomic deprivation and more advanced disease at presentation. Our annual incidence was 12.0 cases per 100,000 children under 16 years old per annum.</p> Conclusion <p>There was no statistically significant difference between socioeconomic deprivation and the incidence of cholesteatomas or the age of patients and the severity of disease at presentation. A significant correlation was found between higher socioeconomic status and more advanced disease.</p>