Diffusion-weighted magnetic resonance imaging (DW-MRI) is a useful method for investigating cholesteatomas since it may be performed without the need for a contrast agent and can prevent unnecessary "second look" operations. This study aims to evaluate the role of DWI-MRI in monitoring residual or recurrent disease and preventing second look procedures when physical examination is difficult or CT is ambiguous. This single centric, cross-sectional study was conducted on 33 patients with suspected cases of attico-antral disease at a tertiary sector, subjected to DWI sequence of MRI for a study period of 1.6 years. The average age of patients was 36 ± 14.40 years with male predominance (66.66%). A right-sided laterality with hearing loss and ear discharge was commonest symptom. MRI findings and surgical presence of cholesteatoma was present in 81.81% cases. Sensitivity, Specificity of MRI in the diagnosis of AAD was 100%. The study concluded that DWI-MRI is an important tool in the diagnosis of suspected cases of AAD with 100% diagnostic test characteristics.