Jahra underwent Left Attico-Antrostomy with Ossicular reconstruction operation on 22 January 2017. During operation Cholesteatoma found in attic region, extending to additus. Cholesteatoma sac along with granulation tissue removed meticulously. Maleus was absent, long process of incus was found eroded but stapes was intact. Incus was reshaped and placed over stapes. Chochal cartilage graft was used to reconstruct attic and meatal wall. Chorda tympani nerve was preserved and temporalis fascia graft placed to repair the ear drum gap. Immediate hearing improvement was observed after 14 postoperative days. The postoperative hearing test revealed normal hearing in the left ear.