Chronic otitis media is an inflammation of the middle ear which persists longer than six weeks. It is characterised by otorrhoea and conductive hearing loss, usually without the presence of pain. Chronic otitis media occurs in both, children and adults, and it is the most common cause of disruption of the auditory ossicle chain, including more than eighty percent of causes. There are four types of chronic otitis media, chronic serous otitis media, chronic suppurative otitis media, chronic otitis media with adhesions and chronic otitis media with cholesteatoma. The treatment starts with antibiotic therapy. If the therapy is unsuccessful, surgical approach is considered. Indications for surgical treatment are appearance of otogenic complications (conductive hearing loss), cholesteatoma and ostitic process, rupture of auditory ossicle chain and persistent perforation. The main goals of surgery are eradication of the pathological process in the middle ear, closure of the eardrum perforation and reconstruction of the auditory ossicle chain. Therefore, the operation is called tympanoplasty with ossiculoplasty. There are three possible approaches to the operating area with endaural approach most commonly used. After approaching the operating area of the middle ear, in presence of ossicle chain damage, ossiculoplasty is performed. Given the finding of the damaged part of the auditory ossicle chain, operations are individualised. Mostly, the incus or a part of the incus is missing. The operation includes reuse of the autologous ossicle if possible, which can be shaped by drilling and placed to its usual place in the chain. If autologic grafts can't be used, other options include heterologous or alloplastic grafts. If eardrum perforation is present, tympanoplasty is performed. Grafts which are used include fascia, perichondrium and most frequently used, cartilage. Tympanoplasty with ossiculoplaty is a successful way of treatment of conductive hearing loss after chronic otitis media. It improves hearing status satisfactorily with low complications rate.