ObjectiveTo evaluate whether bilateral congenital ossicular anomalies (COAs) differ regarding ossicular anomalies and hearing loss severities between the ears of the individual.Study DesignRetrospective case review.SettingTertiary referral academic center.MethodsBetween March 2012 and December 2022, 7 consecutive patients (14 ears) with surgically confirmed bilateral COAs were included in the study. Preoperative pure‐tone thresholds, COA classification according to the Teunissen and Cremers system, surgical procedures, and postoperative audiometric results were compared between the 2 ears of each patient.ResultsThe median age of the patients was 11.5 (range: 6‐25) years. Both ears of each patient were categorized based on the same classification. Three patients possessed class III COAs and the other 4 had class I COAs. The interaural differences in preoperative bone and air conduction thresholds were within 15 dB for all patients. Differences in postoperative air‐bone gaps between ears were not statistically significant. The surgical procedures required for ossicular reconstruction were almost identical for both ears.ConclusionThe severity of ossicular abnormalities and hearing loss in patients with bilateral COAs were symmetrical between ears, thereby enabling prediction of the characteristics of the contralateral ear based on the findings observed in 1 ear. These symmetric clinical features can aid surgeons when operating on the contralateral ear.