Introduction: Tympanic membrane forms a important part of middle ear hearing mechanism .Long standing middle ear inflammation leads to atelectasis of the membrane which gradually results in adhesive otitis media .Material and methods : This is a prospective research was done over 50 candidates of adhesive otitis media to study the outcome of the management of adhesive otitis media tympanoplasty with or without canal wall up mastoidectomy .Results : Both the group showed comparable results with improvement in hearing and state of middle ear on subsequent long term follow up .Conclusions :The outcome of surgical management of adhesive otitis media depends upon patient’s factor and surgeon competency .Moreover it depends patient’s benefit from different approaches