To determine the rates of success of two different techniques of Tympanoplasty. It’s a prospective comparison study. Department of ENT and head and neck surgery, Pakistan institute of medical sciences, Islamabad. Period of study extended from January 1999 to December 2000. This study included 30 patients that underwent tympanoplasty in the department of otolaryngology, head and neck surgery, Pakistan Institute of Medical Sciences Islamabad. Out of these 30 patients, 20 were males and 10 females. 15 cases underwent underlay technique and 15 patients were operated on by overlay technique. Outcome was measured for healing, post operative hearing and incidence of complications. According to this study, the success rate of tympanoplasty in graft uptake by underlay technique was 86% and by overlay technique was 70%. Hearing results were significantly different between overlay and underlay groups. Closure of Air Bone Gap with in 0 - 20 dB in underlay group was 86% while in overlay group it was 69%. The most significant finding in this study was high success rate with underlay technique with low incidence of complications. It was an ideal technique to repair perforations that are small and easily visualized in all quadrants, blunting and lateralization of the grafts were avoided.