[Abstract] Objective To evaluate the clinical effects of endoscopic micro-flap overlay myringoplasty under continuous irrigatting mode of endoscopic ear surgery (CIM-EES). Methods 75 patients with chronic suppurative otitis media that planned to receive myringoplasty were divided into micro-flap group (43 cases,45 ears) and conventional flap with normal flap group (32 cases, 34 ears) according to different methods of tympanomeatal flap. Both groups were treated under CIM-EES with overlay method. Tragus cartilage-perichondrium complex was choosed as the repairing material.Postoperative follow-up was 6~12 months. The operation time and postoperative clinical efficacy of the two groups were compared and analyzed. Results The tympanic membrane were repaired successfully in all patients in both the micro-flap group and the conventional flap group that manifested the success rate of the operation under CIM-EES was 100%. The mean operation time was 19. 6±6.5 min and 39. 1±9.9 min, respectively, and the difference was statistically significant (P<0.001). The mean air conduction threshold of 0.5~4 kHz before operation was 40.16±10.79 dB HL and 41. 58±9.23 dB HL，respectively, and the mean air conduction auditory threshold of 0.5~4 kHz 6 months after operation was 25.56士11.21 dBHL and 26.47 ±10.59 dBHL，respectively. The air conduction hearing among the two groups were both significantly improved after operation comparing with operation before (P<0.001), and there was no statistical significance between the two groups (P>0.05). Conclusion Micro-flap overlay myringoplasty under CIM-EES has a very high success rate of surgery. Comparing with the tympanomeatal flap with normal size, micro-flap can significantly shorten the operation time.