OBJECTIVE: To assess ossicular defects in patients with tubo-type of CSOM in relation to size of tympanic membrane perforation and its associated hearing loss. SETTING: This study was carried out in department of Oto-rhino-laryngology, Vinayaka Mission Medical College, Karaikal. (Tertiary Care hospital). METHODS: The study included 150 patients who attended ENT OPD from May 2012 to May 2013. The patients underwent ossiculoplasty and were diagnosed to have tubo-tympanic type of CSOM. The parameters studied were size of perforation of tympanic membrane, pre-operative hearing levels and intra-operative ossicular defects. RESULTS: Incus was the commonest ossicle affected especially the long process of incus. In some cases the entire incus was absent. Involvement of the incus was seen was highly evident in patients with subtotal perforation of the tympanic membrane. Majority of patients had conductive hearing loss between 39.40 to 59.60 dB in patients having either single or multiple ossicular involvements. CONCLUSIONS: Ossicular defects and associated hearing loss may occur in tubo-tympanic type of CSOM. Ossicular defects were more common in sub-total perforation of tympanic membrane than central perforation. Knowledge gained from this study could be utilized by ENT surgeons in efficient management of tubo-tympanic type of CSOM.