Background: Various modifications in tympanomeatal flap elevation in tympanoplasty were described by otolaryngologist all over the world to achieve best surgical outcome. In this study the surgical and audiological outcomes of anterior tucking tympanomeatal flap elevation and over-under technique of flap elevation were compared in type 1 tympanoplasty. Objective: The aim of this study is to compare surgical outcomes of two techniques of tympanomeatal flap elevation in tympanoplasty. Material and methods: This prospective randomised study included 200 patients. Patients were randomly allocated in 2 groups. Patients were followed for 3 months and compared surgical and audiological outcomes in 2 groups. Result: In anterior tucking (group A) techniques overall success (97.3%) and anterior blunting (9.1%) were more whereas residual perforation (2.7%), granulation formation (2.7%) and lateralisation (0.0%) were less common as compared to over-underlay technique (group B). In over-underlay technique (group B) success, residual perforation, lateralisation and anterior blunting were seen in 82.2%, 17.8%, 4.4%, 2.2% respectively. Conclusion: Both anteriortucking underlay and over-underlay techniques of tympanoplasty are effective surgical technique with satisfactory outcome.