Abstract: Objective To observe the clinical effect of tympanoplasty assisted by otoendoscopy in the treatment of tympanum rupture. Methods A total of 72 patients with tympanic membrane rupture were divided into observation group(tympanic membrane repair under otoendoscopy) and control group(tympanic membrane repair under microscope) with 36 cases in each group. The pain and hearing improvement after operation were assessed. The differences of intraoperative bleeding, operation time and hospitalization time between the two groups were compared. The success rate of operation was counted and the complications were observed. Results After surgical, the degree of pain(1.82±0.44 and 3.25±0.52), point and pneumatic hearing(17.35±2.25 and 28.35±3.68) dB in two groups were significantly lower than those before operation[observation group:(5.25±1.26) and(41.05±5.21) dB, control group:(5.31±1.28) point and(41.22±5.28) point, t=19.803-27.125, all P<0.001], and the degree of pain and pneumatic hearing in the observation group were significantly lower than those in the control group(t=12.596, 15.164, all P<0.001). The one-time success rate of operation in observation group(97.22%) was significantly higher than that in control group(77.78%, χ²=4.571, P=0.033). The overall incidence of complications in the observation group(0.00%) was significantly lower than that in the control group(16.67%, χ²=4.545, P=0.033). Conclusion Minimally invasive tympanoplasty under otoendoscope can effectively improve the hearing of tympanic membrane rupture caused by various reasons. It has little iatrogenic trauma and can reduce the degree of pain response. It has a definite effect and is worthy of clinical application.