As a part of the auditory system, tympanic membrane has an important role in the transmission of a soud wave thus tympanic membrane perforation can be a significant health issue. Tympanic membrane perforation is more common in childhood, the most common cause being chronic otitis media. Respiratory tract inflammations are most commonly found among the pediatric population due to immune system immaturity and anatomical specificities. Furthermore, perforation can occur as a result of trauma or certain precipitating factors which can potentiate perforation development. Most perforations heal spotaneously, but if this is not the case even after a follow-up period of a few months and attempts of conservative treatment, surgical treatment options are considered. Some of the factors that influence decision making regarding the surgical treatment are age, etiology, perforation duration, adenoid vegetations and palatine tonsils condition and contralateral ear condition, while the two medical investigations which are considered the most important in the preoperative evaluation are otoscopy and audiometry. There are three types of surgical approaches to reach tympanic membrane and each of these has its specificities and disadvantages. In addition, there are various tissue types that can be used for typanic membrane reparation and they can be positioned in multiple ways towards the tympanic membrane. If a child has a simple perforation, it is preferable to apply one of the less invasive surgical methods which aims to reduce the duration of operation and postoperative recovery, while at the same time accomplishing an outcome as successful as by other methods. Precondition for successful outcome of tympanoplasty is a good knowledge and compliance in terms of postoperative precautionary measures. For a proper evaluation of surgical outcome, a patient follow-up of at least one year period is required. Just like any other surgical procedure, tympanoplasty carries a risk of complications such as reperforation or retraction pocket development. Prevention of complications consists of knowing indications for tympanoplasty and recognizing risk factors for each patient.