To evaluate the safety and efficacy of endoscopy on tympanic membrane plasty in patients with large tympanic membrane perforation. Methods 43 cases (46 ears) with large perforation of tympanic membrane underwent endoscopic cartilage-perichondrium myringoplasty were analyzed retrospectively. Tympanic membrane healing and hearing were evaluated. Results Of the 46 ears, 3 eras failed to heal and the healing rate was 93.5%. The hearing improvement was satisfactory. 1 patient with delayed facial palsy recovered after drug treatment, and no complications occurred in the rest of the patients. Conclusion The treatment of endoscopic cartilage-perichondrium myringoplasty is relatively simple. The surgical success rate is higher than that under microscope, which is worth popularizing in clinic.