Objective. To assess hearing improvement & TM healing in Cases of Subtotal TM perforation who had tympanoplasty using single layer graft Technique. Method: 18 cases of Subtotal TM perforation had Microscopic postauricular Tympanoplasty using single layer perichondrium / cartilage island graft (composite graft) in underlay manner between 2020 and 2021 and Audiogram was done 1 week & 3 months pre & postoperative respectively. Results: 6 of 18 cases had small residual TM perforation postoperative and preoperative mean ABG was 22.65 ± 8.46 dB and became 20.30 ± 9.83 dB postoperatively .Conclusion: Postauricular Tympanoplasty using single layer graft in is still valuable technique for cases with subtotal TM perforation. Furthermore, the cartilage is more resistant cases with ET dysfunction and can withstand the (-ve) pressure in middle ear.