Chronic suppurative otitis media owing to poor socio-economic status and poor environmental conditions account for morbidity in about 5 % of the total population. ENT surgeons by performing a corrective surgery for chronic otitis media can change the lifestyles of the patient profoundly. The medical line of management only can lessen the severity of the symptoms. Hence based on above findings the present study was planned for Evaluation of Surgical Outcome in Chronic Otitis Media Cases with Cholesteatoma. The present study was planned in, Department of ENT, Nalanda Medical College and Hospital, Patna, Bihar, India. In the present study 20 cases of the patients of chronic otitis media with cholesteatoma of new cases, and previously operated cases with residual or recurrent disease were enrolled and evaluated. All patients underwent satisfactory removal of the disease (mastoidectomy) and hearing reconstruction (tympanoplasty) in a single stage surgery. Temporalis fascia graft was used for reconstruction of the tympanic membrane defect by underlay technique. The data generated from the present study concludes that both procedures have their own advantages and disadvantages and when performed meticulously both serve the purpose of rendering the patient a safe ear. The ICW procedure leaves behind an anatomically normal appearing ear and when quality of life concerns needs to be addressed this should be the procedure of choice, with advancement in technology and availability of angled endoscopes which have marched well into otology.