Introduction Tympanoplasty is the treatment of choice for patients suffering with Chronic Otitis Media (COM). Outcome of tympanoplasty depends on various factors like size and location of tympanic membrane perforation, ear ossicles, degree of otorrhea, cholesteatoma, smoking history, granulation tissue etc. Prediction of outcome of tympanoplasty procedure prior to surgery with respect to graft uptake and hearing improvement can serve as a crucial factor in decision making in resource limited nations. Hence, a study was conducted to evaluate the role of Middle Ear Risk Indices (MERI) in predicting the outcome among patients undergoing tympanoplasty procedure. Materials and Methods A prospective study at a tertiary care centre was conducted for a duration of 2 years among 60 patients with COM who underwent tympanoplasty. Results The mean age of patients was 25.32 ± 8.43 years with a male to female ratio of 3:2. Majority (78.46%) of the patients had Mild MERI score; 18.46% patients had moderate MERI score and 3.08% patients had severe MERI risk score. The difference in mean Air –Bone (AB) gap in the mild and moderate MERI groups’ pre and post operatively was found to be statistically highly significant (p<0.001). Conclusion Lower MERI scores prior to surgery showed significantly better outcomes with respect to graft uptake, degree of AB gap closure and hearing improvement.