Aim: To evaluate and compare the surgical outcomes of tympanoplasty using temporalis fascia, cartilage, and perichondrium graft materials in patients with chronic otitis media. Material and Methods: This prospective study included 90 patients with chronic otitis media, divided into three groups of 30 each based on the graft material used: temporalis fascia (Group A), cartilage (Group B), and perichondrium (Group C). Patients underwent tympanoplasty using a standardized postauricular approach. Surgical outcomes were assessed through graft success rates, hearing improvement, and postoperative complications. Statistical analysis was conducted using SPSS version 25.0, with significance set at p < 0.05. Results: Graft success rates were 86.67% in Group A, 90.00% in Group B, and 93.33% in Group C, with no statistically significant difference (p = 0.58). The mean hearing improvement was highest in Group C (16.55 dB) compared to Groups A and B (14.95 dB each), though not statistically significant (p = 0.49). Postoperative complications, including infection and residual perforation, were low and comparable across all groups (p > 0.05). Multiple regression analysis identified graft material (p < 0.05) and preoperative air-bone gap (p = 0.05) as significant predictors of surgical outcomes. Conclusion: Tympanoplasty using all three graft materials demonstrated high success rates and significant hearing improvement, with perichondrium showing a slight advantage in outcomes. The low complication rates across groups affirm the safety of these materials, emphasizing the importance of tailored graft selection based on individual patient factors.