The measurement of otoacoustic emissions is dependent on both the forward path from the ear canal to the cochlea and the reverse path from the cochlea to the ear canal. Negative middle-ear pressure caused by Eustachian tube dysfunction attenuates the OAE response, particularly for low frequencies. This study explored the effect of compensating for deviant middle-ear pressure on TEOAE amplitude in 59 children with middle-ear pathology. TEOAE amplitudes were compared between measurements made at ambient ear canal pressure and peak middle-ear pressure for the mean broadband response as well as the 1, 2, 3 and 4 kHz response. Peak pressure ranged from -263 to +25 daPa (mean = -85 daPa). TEOAE amplitudes measured at peak pressure were significantly greater than those made at ambient pressure for the overall TEOAE amplitude (2 dB), and the 1 kHz (4.7 dB) and 2 kHz (2.6 dB) bands. This suggests that compensating for deviations in middle-ear pressure for TEOAE measurements may improve OAE detection, thus minimizing false positive results of sensorineural hearing attributed to middle-ear dysfunction. The Titan TEOAE module is capable to measuring OAEs at ambient and tympanic peak pressure.