Objective: This study describes a transcanal endoscopic approach for MRM technique with ossculoplasty and highlights ist advantages for removal limited Cholesteatoma in the tympanum and antrum. Study design. Retrospective review of surgical 'cases using a transcanal endoscopic approach for MRM. Methods..The author's database of major otological procedures was reviewed to identify cases in which a transcanal approach for MRM was utilized to remove disease confined to the tympanum-antrum. Cases in which disease progressed into the mastoid, requiring a postauricular approach were excluded. Patient demographics, ear pathology, surgical variables, postoperative variables, audiometric data and CT scan of temporal bone were recorded. Standard, descriptive statistics were used to summarize demographic and clinical characteristics of study cases, intraoperative video segment were recorded and edited to depict the operative technique. Results: Transcanal antrotomy for MRM was performed on 45 patients. Ossicular reconstruction was performed in 37 patients during initial surgery. Ceramic prothese was used in 77,8 percent of cases. No major complications occurred postoperatively. No patients had recurrent disease in the antrum. Closure of air-bone gap to within 20 dB occurred in 85 percent of cases. Conclusions: Transcanal antrotomy for MRM is a safe, efficacious, and minimally-invasive approach to remove disease from the middle ear and antrum. This approach allows for optimal exposure of the antrum and is less invasive than postauricular and endaural approaches. With transcanal antrotomy, secon stage procedures can be avoided in many cases resulting in reduced and improved quality of life.