OBJECTIVE: To study the commonest ossicular pathology in CSOM (Chronic suppurative otitis media) and how the results vary with various techniques and graft materials used for ossicular reconstruction. Design: Prospective study Setting: Department of E.N.T, Vinayaka Missions Medical College and Hospital, Karaikal, Puducherry (U.T). METHODS: A total of 80 patients, between 11 - 50 years of age group with CSOM requiring surgical treatment who were treated in the Vinayaka Missions Medical College., Hospital, Karaikal within a period of 18 months from July 2011 to December 2012 were taken into study. RESULTS: The Commonest ossicular pathology is necrosis of incus. (95%). A closure of air bone gap within 20dB was achieved in 72.2% patients, where, malleus stapes assembly was done. Better results were obtained by using autogenous incus remnant. CONCLUSION: In this era where a large variety of artificial prosthetic materials are being used to replace and to reconstruct the ossicular chain, autograft still plays significant role.