Background: Endoscopy is performed by otorhinolaryngologists in the clinical setting as part of the otological examination to assess the extent of middle ear disease and assist in planning the surgical approach. This study is aimed at assessing the role of oto-endoscopes in evaluating the middle ear structures preoperatively in cases of mucosal type of chronic suppurative otitis media. Method: In this prospective study, 45 patients with CSOM were subjected to otoendoscopy using 0 and 30-degree Hopkins endoscope. The various middle ear structures and hidden spaces like facial recess, sinus tympani, hypotympanum and protympanic segment of the eustachian tube were visualized preoperatively. Result: Middle ear structures and blind niches were better evaluated preoperatively using otoendoscopes and a definitive operative plan was formulated. Adhesions and secretions at tympanic orifice of the Eustachian tube opening and congested middle ear mucosa were identified preoperatively to incorporate a better management plan. Conclusion: Preoperative otoendoscopy could be utilized to improve the evaluation of hidden middle ear recesses and structures, particularly if there is a potentially recrudescent pathology, thus providing better surgical outcome for patients.