Background: Tympanic membrane perforation (TMP) results mainly from infectious and traumatic causes. Perforations result from acute otitis media and trauma heal spontaneously in the majority of cases. But if there is a repeated infection or if the infection is persistent, there is less possibility of spontaneous healing of this perforation. Objective: To assess the effectiveness of adding platelet rich plasma (PRP) or hyaluronic acid (HA) to temporalis fascia graft to enhance healing of tympanic membrane in comparing with temporalis fascia graft alone in case of simple myringoplasty. Patients and methods: This was a prospective randomized comparative study on 90 patients [30 patients with temporalis fascia alone ,30 patients with temporalis fascia with PRP and 30 patients with temporalis fascia with HA] which was conducted at the Otolaryngology Department Al-Hussein Bab-Al-Shaaria Al-Azhar University hospital and Hearing and Speech institute from september 2020 till August 2021. Results: There was a significant difference between the three groups regarding postoperative pure tone audiometery (PTA) only. Meanwhile, there was a significant decrease in pure tone audiometery (PTA) postoperatively in the three groups. There was a statistically significant difference in the results of tympanic membrane healing and pure tone audiometery (PTA) pre and post-operatively after using Esterified Hyaluronic acid and platelet rich plasma (PRP) with temporalis fascia graft. There were no statistically significant differences as regard the success rate between patients who underwent temporalis fascia graft platelet rich plasma (PRPG), temporalis fascia graft with Hyaluronic acid and patients who underwent temporalis fascia graft alone. Conclusion: FGM with adding PRP or HA was slightly more successful in closure of TM perforation than pure FGM in case of TM perforation,