OBJECTIVE Underlay Tympanoplasty with superiorly based circumferential flap for dry subtotal perforations. STUDY DESIGN A prospective study of cases with dry subtotal perforations, which underwent surgery between August 2001-Feb. 2004. SETTING Study was conducted on patients attending ENT OPD in S.M.S. Medical College and Hospital from August 2001-Feb. 2004 with dry subtotal perforations. RESULTS It was noted that 89% of the cases were in the age group of 11 to 40 years, while one case was of 7 years of age and 9% of cases were between the age of 41-50. 50% of the cases had dry ear for less than 3 months while 75% of cases had dry ear for less than 1 year. Graft take rate was 97% with completely healed tympanic membrane. Rejection of the graft was observed in 2% of the cases. Hearing gain of 10-30dB was achieved in 95% of the cases. 7% of the cases suffered minor complications like otitis media with effusion (2%) retraction (2%) and lateralization (1%). CONCLUSION Duration for which ear has been dry did not affect the results. 49% of cases had dry ear for less than 3 months, with good graft take up rate and hearing gain. Pneumatization of mastoids, had a direct relationship with, post operative hearing gain, which ranged from 10-30 dB, in 95% of the cases. We observed, 97% graft take rate. Rejection of the graft was found in only 2% of the cases. 97% of the graft take rate and good hearing gain in our study can be correlated with expertise technique to deal with subtotal perforations.