Woke up in the middle of the night to my left ear feeling super plugged and hurting badly what's wrong?

Ear issues: Without examining you, I can not tell you what is wrong, but I would be concerned for a possible ear infection. Get seen and properly evaluated and diagnosed for any possible treatment to start. Best wishes.

You may have: an "effusion" or fluid in your middle ear from infection either viral or bacterial - putting pressure on the inside of your ear drum. You may get better all on your own taking Tylenol (acetaminophen) - decongestants or if symptoms last may need prescription medicines- not necessarily antibiotics.