Objectives:The aim of the study was to contrast the healing times between patients undergoing Modified Radical Mastoidectomy (MRM) with and without mastoid cavity obliteration in Chronic Otitis Media squamous active type. It sought to contribute insights into the efficacy of these surgical approaches for mastoid cavity management. Methods:The study, conducted in the ENT departmentat MGM Medical College, Jamshedpur, Jharkhand, India over one year, focused on COM squamous active patients aged ≥ 8 years. It employed a comparative approach, randomly dividing 30 patients into two groups: Group A (MRM with obliteration) and Group B (only MRM). Surgical procedures involved a post-aural approach, tympanomeatal flap creation, inferiorly based musculofascioperiosteal flap, CWD mastoidectomy, and mastoid cavity obliteration using bone chips and dust, followed by standard wound closure and postoperative care. Results:In this study, the gender distribution revealed 53.3% males and 46.6% females in both obliterated and non-obliterated groups, without statistical significance. Predominantly, the 10-19 age group had 40% non-obliterated and 66.6% obliterated cases. In the 20-29 age group, there were 40% non-obliterated and 20% obliterated cases. The mean duration of healing for Group A was 11.86 weeks, significantly faster than Group B at 13.95 weeks (p = 0.005). Conclusion:This study reveals thatmastoid obliteration significantly reduced healing time compared to non-obliterated cases in patients with COM squamosal active disease. The study underscores the effectiveness of the inferiorly based musculofascioperiosteal flap technique in achieving faster recovery. These findings contribute valuable insights into optimizing surgical approaches for improved outcomes in chronic ear infection cases.