Abstract: Objective To compare the efficacy of complete and open radical mastoidectomy combined with tympanoplasty for treatment of middle ear cholesteatoma and chronic suppurative otitis media. Methods Retrospective analysis was performed using clinical data from patients with middle ear cholesteatoma and chronic suppurative otitis media who were admitted into the Affiliated Hospital of Xuzhou Medical University from June 2015 to June 2019. According to their corresponding surgical methods, the patients were divided into two groups: a complete group which received complete modified radical mastoidectomy combined with tympanoplasty and an open group which received open mastoidectomy combined with tympanoplasty. The two groups were compared for postoperative dry ear time, complication and relapse incidences after surgery, and air bone gap (ABG) before and after surgery. Results The average time of dry ears was (38.9±8.5) d for the open group, and was (19.8±5.2) d for the complete group, which was statistically different (P<0.05). There were 24 cases (35%) of complications in the open group and 3 cases (13%) of complications in the complete group. The incidence of relapse was 21% for the complete group, which was remarkably higher than 4% for the open group (P<0.05). There was no statistical difference in ABG between the two groups before surgery (P>0.05). After surgery, the complete group presented remarkably better ABG (14.78±4.05) dB than the open group (19.55±5.54) dB (P<0.05). Conclusions Compared with open mastoidectomy, complete radical mastoidectomy combined with tympanoplasty presents better hearing, few complications and short dry ear time, despite of a high incidence of relapse.