Chronic Suppurative Otitis Media (CSOM) is a common condition of the middle ear that may lead to serious complications if not properly managed. Several environmental and host-related factors are believed to influence the clinical presentation of CSOM. However, evidence examining their association with specific CSOM subtypes remains limited. This research was conducted to examine factors associated with different types of CSOM. A cross-sectional analytical approach was applied at Dr. Mohammad Hoesin General Hospital, Palembang, during July–September 2025, with a total of 68 CSOM patients participating in the study. Data on age, sex, cigarette smoke exposure, history of upper respiratory tract infections (URTIs), and allergic rhinitis were collected using structured interviews. The CSOM type was determined through otoscopic examination. The chi-square test was applied for bivariate analysis, and multivariable logistic regression analysis was performed to obtain adjusted odds ratios (aOR). Cigarette smoke exposure (aOR = 8.28; 95% CI: 1.85–37.01) and allergic rhinitis (aOR = 5.73; 95% CI: 1.31–24.99) were significantly associated with the atticoantral type of CSOM, whereas recurrent URTIs showed a positive association that was not statistically significant after controlling for other variables. (aOR = 2.64; 95% CI: 0.59–11.80). The results of this study imply that cigarette smoke exposure and allergic rhinitis are significantly associated with the atticoantral type of CSOM, while recurrent URTIs may act as a contributing factor.