Objective. To test the hypothesis that otalgia occurs frequently in CMDs patients and increases with the severity of Temporomandibular internal derangements (TMJ-IDs). Method. 221 CMDs patients and two control groups were evaluated. We used clinical examination, questionnaires, biomechanical tests and established criteria for TMJ-IDs. Individuals were allocated to TMJ-ID groups to compare otalgia frequencies. Following assessment of frequency of otalgia in the CMD group, individuals were allocated to TMJ-ID subgroups with capsulitis, retrodiskal pain, disk-attachment pain, arthralgia and osteoarthritis (OA). Results. Otalgia frequency was higher in CMDs patients than in the two control groups and the difference was statistically significant (p<0.0001 and p><0.003). Otalgia frequency increased with the severity of TMJ-IDs (Chi-square trend analysis p><0.0001). Frequency of otalgia was higher in the disk attachment pain, arthralgia and osteoarthritis subgroups. Conclusion. The frequency of otalgia was higher in CMDs and increases with the severity of TMJ-ID. Those presenting more severe TMJ-IDs demonstrated higher frequencies of otalgia. The results of this study suggest a relationship between disk displacement, stages of internal joint derangements, pain and TMJ otalgia.>