Background: Surgical closure of anterior tympanic membrane perforation (ATMP) has poor outcome due to many reasons as reduced vascular supply, limited anterior margin, poor visualization, and inadequate graft stabilization. Platelet Rich Plasma (PRP) can be defined as an autologous concentration of human platelets in a small volume of plasma. Objective: To evaluate the effect of adding PRP on healing of ATMP by using underlay technique myringoplasty. Patients and Methods: A prospective randomized study included 40 patients with chronic dry ATMP, attending the ENT outpatient clinics of Al-Azhar University Hospitals between June 2015 and Aug 2016. They were randomly divided into two equal groups: Study group underwent underlay myringoplasty by temporalis facia graft with adding PRP, and control group underwent underlay myringoplasty with only temporalis facia graft. Patients were seen 1, 2, 3 months after surgery. Results: In the study group, 70% were males and 30% were females, and in control group 55% were males and 45% were females, with a mean age of 35.1 ± 5.7 years in study group, and 32.6 ± 7.6 years in the control group. In study group complete healing of perforation was 85%, reduction of perforation size was 10% and failure of healing was 5%, whereas in control group complete healing of perforation was 45%, reduction of perforation size was 15% and failure of healing was 40%. Conclusion: Addition of PRP to fascia graft and using underlay technique myringoplasty increase the incidence of healing of ATMP with decrease post-operative complication.