Cholesteatoma is a serious complication of chronic suppurative media otitis media. It was found to be more aggressive and extensive in children. Opinion vary about the best method for management of cholesteatoama in children. Some prefer intact canal wall technique as it dose not leave a large cavity with its problems but it is accompanied with a higher rate of residual and recurrent disease. Others see that although canal wall down lead to a large cavity yet it is considered much more safer in children.