<p>Subtotal tympanic membrane perforations present a surgical challenge due to inadequate anterior support, increasing the risk of graft medialization and failure. Several tympanoplasty techniques have been developed to address this issue, among which the circumferential flap and anterior tucking approaches are commonly practiced. To compare the outcomes of Circumferential Flap Tympanoplasty and Anterior Tucking Tympanoplasty in terms of graft uptake, hearing improvement, and postoperative complications. This prospective comparative study included 50 patients with inactive mucosal chronic otitis media and subtotal perforations. Patients were divided into two groups of 25 each: Group A underwent Circumferential Flap Tympanoplasty, and Group B underwent Anterior Tucking Tympanoplasty. All surgeries were performed using temporalis fascia graft underlay technique. Graft uptake was assessed by otoendoscopy, and hearing outcomes were evaluated using Pure Tone Audiometry at 4 weeks postoperatively. Graft uptake was 96% in Group A and 92% in Group B. Both groups demonstrated statistically significant improvement in hearing thresholds (<i>p</i> &lt; 0.0001). Mean ABG closure was slightly better in the Circumferential Flap group. Anterior blunting was observed in 8% of patients in Group B, whereas no major complication occurred in Group A. Both techniques are effective in restoring tympanic membrane integrity and improving hearing. However, the Circumferential Flap technique offers a marginal advantage in graft stability and lower complication rate, making it a preferable option for subtotal perforation repair.</p>