Tympanic membrane perforations are encountered by Otologists in clinical practice. It is the most common cause of hearing loss. We in the present study tried to evaluate the size and location of perforation to the degree of hearing loss and the outcome of treatment of these patients in our hospital. Methods: This prospective observational study was conducted in the Department of ENT, Rajiv Gandhi Institute of Medical Sciences [RIMS], Adilabad. A detailed clinical history including the name, age, sex, address, occupation, presenting complains, past history and physical examination and ENT examinations under microscopy was done to assess the size, site, and shape of perforation including Pure Tone Audiometry. All the patients underwent Myringoplasty through postaural approach using underlay technique taking temporalis fascia as graft material. Results: A total of n= 40 patients were included in the study male patients were n=24(60%) and n=16 (40%) were female patients and the male to female ratio was 6:4 with the predominance of male patients common cause of the injuries was related to RTA 18(45%). The right ear was involved in n=18(45%) of cases left ear was involved in n=21 (52.5%) and bilateral involvement was seen in n=1(2.5%) of cases. n=40 patients underwent myringoplasty in the Grade I perforations the preoperative hearing loss was 29.59 ± 6.65 and in the postoperative, after 12 weeks 17.05 ± 4.4 dB and the audiometric gain was 12.54 dB. In Grade II it was 35.40 ± 5.44 dB and postoperative 12 weeks were 18.51 ± 3.5 dB audiometric gains was 16.89 dB. The Grade III had pre-operative levels 37.95 ± 6.10 dB and the audiometric gain 19.84 dB and similarly in Grade IV 37.95 ± 6.10 dB and the audiometric gain was 25.95 dB. Conclusion: It can be concluded the tympanic membrane perforations are very common in men with the frequency of posterior perforations are greater and the hearing loss does not vary substantially with the location of the perforation. Surgical intervention of perforations is required when they fail to heal spontaneously and the audiometric gain following myringoplasty was more where the size of perforations was large