Adipose myringoplasty is presented as a simple and cost‐effective technique in managing small tympanic membrane perforations in children. A review of 76 fat plug myringoplasties performed on 62 children with drum perforations over a 15‐year period was done. Fifty‐nine myringoplasties were postinflammatory and/or after extrusion of pressure‐equalizing (PE) tubes. Sixteen were residual perforations following temporalis fascia tympanoplasty, and one was posttraumatic perforation. Criteria for selection, operative technique, and results are discussed.