Objective: To observe the curative effect of endoscopic myringoplasty by inlay method and sandwich method with chronic suppurative otitis media. Methods: We retrospectively analyzed the clinical data of patients with chronic suppurative otitis media who underwent myringoplasty via endoscope between June 2019 and June 2021, and compared the repaired feature of tympanic membrane and hearing improvement pre- and post-operatively. Results: A total of 66 patients were enrolled for the observation. The same surgeon performed type I tympanoplasty with the inlay method or sandwich method (33 cases in each group). In the inlay group, 31 of 33 patients achieved a satisfactory healing of tympanic membrane perforation with a healing rate of 93.9%. In the sandwich group, 32 of 33 patients with tympanic membrane perforation got repaired successfully with a healing rate of 97%. In the inlay group, the pre-operative and post-operative air-bone gap was 21.76±9.43dBHL and 15.97±8.60dBHL, respectively, with an increase of 6dBHL on average (P=0.011). In the sandwich group, the pre-operative and post-operative air-bone gap was 19.06±8.40dBHL and 12.30±7.23dBHL, respectively, with an increase of 7dBHL on average(P=0.001). Conclusion: The inlay method and the sandwich method under the endoscope can achieve an ideal tympanic membrane healing and hearing improvement indistinguishably. In addition, endoscopic surgery was less time-consuming and needed shorter length of stay in hospital. There was bright future for the development of otoscopic surgery.