The average preoperative hearing loss (air-bone gap) was 25 dB in the endoscope group and 26 dB in the microscope group 15 cases were done by the microscope and the other 15 were done by the endoscope. In terms of graft up take and complete closure of the tympanic membrane perforation; patients had a successful outcome in the endoscope group and 13 (86%) patients had a successful outcome in the microscope group. In terms of hearing improvement; the average air bone gap has been reduced to be less than 20Db in 90% in the endoscopic group and in 88% in the microscopic group presenting no statistically significant difference. The endoscope was superior to the microscope in terms of cosmosis, perating time and post-operative recovery .the procedure is very well tolerated by patients with no or minimal pain in most of cases.