Chronic otitis media with persistent tympanic membrane perforation remains a challenging issue in pediatric otology. Objective: To examine the outcomes of autocartilaginous tympanoplasty in children with total and subtotal tympanic membrane defects. Methods and materials: Eighteen patients (age range: 3-15 years) underwent surgical treatment using the retroauricular approach. A cartilage graft harvested from the tragus and temporal fascia was utilized for tympanic membrane reconstruction. Results: Postoperative evaluations revealed successful restoration of tympanic membrane integrity in 88.8% of cases and hearing improvement in 94.4% of cases in the long-term follow-up. Auto Cartilaginous tympanoplasty demonstrates promise for enhancing the efficacy of tympanoplasty in pediatric otorhinolaryngology.