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Objectives: To determine the efficacy of tragal cartilage graft in tympanoplasty type I. Study Design: Quasi-experimental study. Setting: Department of ENT, Head and Neck Surgery, Medical Teaching Institute (MTI), Lady Reading Hospital (LRH), Peshawar, Pakistan. Period: From Jan. 2017 to Dec. 2017 (One Year). Material & Methods: A total of forty four patient fulfilling inclusion criteria were included in this study. All the patients were assessed in terms of detail history, thorough examination focusing on ENT findings. Pure Tone Audiometry (PTA) was performed pre-operative and post-operative at 3 and 6 months interval for the frequencies of 0.5, 1, 2,4 Hz. Data were analyzed using SPSS (version 16). Paired sample t-test of significance was used. The confidence interval was set to 95% and P-value <0.05 was considered significant. Results: Out of 44 patients males were 24 (54.54%), female 20 (45.45%) with Male: Female ratio of 1.2:1. Mean age of the patients was 28. 47 + SD 7.26 Years. There was statistically significant difference between the pre and post-op air conduction (p<.001), and pre-op and post-op air bone gap (p<.001).There was subjectively significant hearing improvement in 31 patients (70.5%). Cartilage graft was taken in 43 patients with success rate of 97.7%. Conclusion: Tragal cartilage is an effective graft material, which yields good results in terms of graft take up, hearing improvement and minimum complication, postoperative healing and acoustic properties.

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