Introduction: Tympanoplasty is defined as a surgical procedure to eradicate infection and restore the function of the middle ear. Different graft materials have been tried for reconstruction of the defect in the tympanic membrane and temporalis fascia is the most common auto graft used. Aim: to demonstrate the long term anatomical and functional outcomes of underlay tympanoplasty using temporalis fascia graft in patients with COM with subtotal perforations. Method: This prospective study was conducted in the department of Otorhinolaryngology and Head and Neck surgery, RNT medical College and MB hospital, Udaipur. Patients attending the outpatient department of Otorhinolaryngology were screened and 50 patients were included in the study. Results: In our study, the graft uptake rate was 96%. Conclusion: Patients having discharge duration for less than 5 years had better graft uptake as compared to patients who had discharged for longer duration.