Background: Size and site of tympanic membrane perforation is proportionate to degree of hearing loss, larger the perforation, greater the hearing loss. The present study was conducted to assess the size and site of tympanic membrane perforation and hearing loss. Materials & Methods: 75 patients with tympanic membrane perforation of both genders were divided into 3 groups based on size of perforation such as group I with 0- 9mm2 , group II with 10-30mm2 and group III with >30mm2 perforation. Site was anterior, posterior and multiple. Hearing loss was calculated. Results: Group I patients had 28.4 dB, group II had 382 dB and group III had 47.5 dB hearing loss. In group I, anterior site was seen in 16, posterior in 5 and multiple in 4 cases, in group II, anterior in 8, posterior in 7 and multiple in 10 cases and in group III, anterior in 8, posterior in 5 and multiple in 12 cases. The difference was significant (P< 0.05). Conclusion: As the size of the perforation increased, hearing loss also increased.