Ear pain is a frequent childhood complaint in primary care, usually caused by benign conditions. In rural settings, however, children’s involvement in agricultural activities increases exposure to insects and environmental hazards. When several children present with similar symptoms within a short period, family physicians can identify shared environmental patterns. This case series describes a cluster of children whose acute ear pain was linked to a common agricultural exposure.Over three consecutive days, four children aged 5–11 presented to a family health center in a semi-rural district with acute ear pain. Otoscopic examination revealed small insects in the external auditory canal in all cases. Insects were removed manually and with saline irrigation; topical therapy was used when mild inflammation was present. Environmental histories were obtained from families, focusing on outdoor activities and contact with vegetation. All four families independently reported purslane-gathering in agricultural fields during the same week, where children sat or lay on dense vegetation. No systemic symptoms or tick exposure were identified at presentation or follow-up. Families received counseling on insect and tick protection, and the cluster was reported to preventive health authorities.This case series highlights an unusual environmental presentation in primary care: multiple children developing insects in the ear canal after participating in the same agricultural activity. It shows how primary care clinicians can detect environmental risks through pattern recognition, even without formal public health alerts.Similar pediatric complaints occurring in clusters should prompt evaluation for shared environmental exposures. In rural areas, routine counseling on insect and tick prevention is essential. Improving environmental history-taking skills can support earlier recognition of vector-related hazardsInsects in the ear canal occur more often in rural areas, especially during summer. While isolated cases are usually straightforward, clusters require broader environmental assessment to prevent recurrence and exclude co-exposures such as ticks, which may transmit serious infections.Environmental history-taking combined with pattern recognition is essential in pediatric primary care. Family physicians should identify shared exposures and provide preventive advice to protect children in agricultural communities. MeSH: Ear Pain; Insect; Environmental Exposure; Children; Primary Care