Introduction: Otitis media is a prevalent global medical condition. Tubo-tympanic chronic otitis media often requires tympanoplasty, highlighting the need to assess severity and predict outcomes. The Middle Ear Risk Index (MERI) score predicts tympanoplasty results and correlates inversely with graft success and hearing improvement. This study aimed to evaluate the MERI score for mild middle ear pathologies and analyse surgical outcomes in tubotympanic chronic otitis media cases to the MERI score. Methods: This prospective study was conducted at the Department of ENT, Aarupadai Veedu Medical College and Hospital, involving 50 patients with chronic suppurative otitis media and conductive hearing impairment. The study lasted 8 months, only including patients with a MERI score of 1-3, indicating mild conditions. Pure tone audiometry was performed preoperatively, and all patients underwent tympanoplasty using the underlay technique with temporalis fascia as the graft. Post-operative evaluations occurred in the second week, with follow-up audiometry at one and three months. Results: The study included 50 patients with a mild MERI score. Males represented 56% of the participants. The predominant age group was 30 to 35 years, constituting 40% of the population. Patients with a mild MERI score demonstrated a statistically significant improvement in hearing post-surgery. Conclusion: The MERI score is a valuable tool for assessing tympanoplasty effectiveness. Keywords: Tympanoplasty, meri score, chronic otitis media.