Tympanic membrane perforation is mostly due to infection, trauma or Post Tympanostomy tube insertion. Mostly it heals spontaneously; however recurrent infection may interfere with regenerative process and result in chronic perforation. Myringoplasty is one of the most commonly performed otologic surgical procedures, which involves use of graft material to repair of tympanic membrane perforation. Since the development of Myringoplasty surgery, various graft materials have been used for repair of tympanic membrane perforation. These graft materials can be autologous, homologous or synthetic materials. Nowadays, Autologous temporalis fascia graft is the most widely used graft material followed by perichondium. Temporalis fascia graft needs external incision and possible visible scar which was used since 1950. The purpose of Fat Graft Myringoplasty is to repair such perforation and tends to improve hearing and eliminate the susceptibility to middle ear infection. The Fat Graft Myringoplasty was 1st introduced by Ringer berg28 in 1962 as an Office based Procedure.ear lobule fat was used as graft in this study. Fat graft Myringoplasty is done by transcanal technique cy using Otoendoscopic guidance. Mostly done under local anesthesia. patient can be discharged on the same day. This study evaluates the efficacy of fat graft myringoplasty.