The aim of the study is to assess and correlate the stage of cholesteatoma with its surgical outcome using the ChOLE classification, and thus revalidate it. Study Design: This was a prospective, observational study conducted in the Department of ENT, Head and Neck Surgery at SRIHER from Dec 2020 to Dec 2022. Sample Size: A total of 73 patients with acquired cholesteatoma. Out of the 73 patients, 15 patients (20.5%) were classified as stage I, 53 patients (72.6%) as stage II, and 5 patients (6.8%) as stage III. All patients with ChOLE I underwent canal wall up procedures, with specific approaches including cortical mastoidectomy with atticoantrostomy in 11 patients, inside-out mastoidectomy with transcanal approach in 3 patients, and post-aural approach in 1 patient. For ChOLE II patients, 19 underwent canal wall lowering, while the remaining 34 had canal wall up procedures, with 21 undergoing inside-out mastoidectomy with a post-aural approach. Among the 5 stage III patients, 4 underwent canal wall down mastoidectomy. Post-operative hearing outcomes showed significant improvements in ChOLE I and II stages, with pre-operative AC PTA and post-operative AC PTA p-values of 0.001 and 0.07, respectively. The pre-operative and post-operative ABG was significant only in ChOLE I. There was a trend of increasing ABG towards ChOLE III. Overall, hearing outcomes were good for all patients, with significant improvements in AC and ABG (