Objective To investigate the methodology and clinical effect of application of auricular cartilage with perichondrium to myringoplasty of patients with large tympanic membrane perforation. Methods Myringoplasty using auricular cartilage with perichondrium as transplant was performed in 36 cases (40 ears) (cartilage with perichondrium group) and that using temporalis fascia was performed in 46 cases (46 ears) (temporalis fascia group). As for the myringoplasty using auricular cartilage with perichondrium as transplant, postauricular incision was adopted and auricular cartilage with perichondrium was obtained, then the cartilage was cut into 2~3 strips by overlaping each other or 2~3 strips of cartilage perichondrium with the concavity towards the tympanic cavity to repair tympanic membrane perforation. The ossicular chain was reconstructed at the same time. The therapeutic effect of myringoplasty by the two methods was comparatively analysed. Results All the patientes were followed up for one year postoperatively. The healing rate of the cartilage with perichondrium group was 95.0% (38/40), while that of the fascia group was 89.1% (41/46). The difference was insignificant (P>0.05). As for tympanic perforation with calcified plaque, the perforation was not cured in 5 of 17 ears (29.4%) in the fascia group while that was in 1 of 20 ears (5.0%) in the cartilage with perichondrium group with significant difference (P<0.05). The average pure tone threshold of air conduction in the cartilage with perichondrium group was 36.9 dB with an average airbone gap of 17.8 dB, and those of the fascia group were 35.5 dB and 15.9 dB respectively with insignificant differences. Conclusion Myringoplasty with auricular cartilage with perichondrium is a reliable method to repair tympanic membrane perforation, especially predominant in the repair of large perforation tympanic membrane with calcified plaque