Ear disease, involving the middle and external ear, is commonly reported in pet rabbits, with lop-eared breeds predisposed. CT is the most reliable imaging modality for identifying otitis media (OM) in rabbits. This study aimed to develop a CT-based grading scale to classify the severity of CT changes in rabbits with presumed OM. Three observers independently reviewed CT images of 36 rabbits with OM. For both OM and material within the external ear canal, a grade of I to IV was used, (I=mild, IV=severe disease) and the level of agreement between reviewers was statistically evaluated. The study demonstrated that grades from the three reviewers showed a strong level of interobserver agreement. Comparisons between clinical signs and CT grade were also evaluated. Rabbits with grade IV OM had a high grade of material in the external ear canal. A high proportion of rabbits (83 per cent) underwent CT scanning conscious, demonstrating that diagnostic quality CT images are achievable without the need for anaesthetic intervention, minimising patient risk. This novel CT-based grading scale provides a methodology to correlate grade of disease with clinical signs, ear canal cytology, predisposing factors, treatment options and outcomes for rabbits with ear disease.