Objective: This prospective study describes the use of autologous conchal cartilage in retracted tympanic membranes in children. METHODS: The setting is a tertiary ENT referral centre. All patients were screened from schools, aged between 4 and 14 years, who had limited cholesteatoma of mesotympanum, not extending to the mastoid antrum. On exploration, the postero superior quadrant was exposed after trans canal drilling; the retracted TM was excised piecemeal. The resulting bony defect was reconstructed with harvested conchal cartilage, in the same setting. This cartilage prevents recurrence of retraction. The graft on contact with the stapes head gave an added benefit of hearing gain, in spite of the incus being eroded and its remnant being removed. RESULTS: 20 of the 24 ears operated were available for follow-up. Of these20 cases, 15 had post op Air-bone gap (ABG) of ≤20dB (75%). There was no extrusion and no case of worsening of hearing. The mean hearing gain was 11.75 dB. CONCLUSION: The authors are satisfied with the outcome of using conchal cartilage to reconstruct postero superior bony defect, after limited cholesteatoma surgery. This cartilage simulates the curvature of the TM. This is done in the same sitting, and in the 13.6 months follow-up available, promises to be a reliable method in our experience.