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Background and Objectives To describe and evaluate modified circumferential subannulartympanoplasty (MCST) via endoscopic approach, we compared the results of MCST tothose of the underlay technique and the results of previous studies. Subjects and Method A retrospective comparative study was conducted of 31 patients whounderwent endoscopic transcanal tympanoplasty. Patients were classified into the MCSTgroup (n=11) and the underlay group (n=20) according to the graft technique. Demographicdata, size and location of the perforation, pre- and postoperative hearing, operating time, complicationrate, and graft success rate were analyzed in each group. Results No significant differences between the two groups were observed in the demographicdata or the locations of the perforations. The sizes of the perforations were 31.4±14.3% and25.0±18.1%, respectively. The average operating times were 68.6±16.5 min and 64.9±9.3 min,respectively, and canaloplasty was not required in any patient. The postoperative hearing improvementand air-bone gap were not significantly different. No postoperative complicationswere observed in either group. Conclusion MCST is a feasible and effective technique for endoscopic transcanal tympanoplasty. The postoperative results and operating times of MCST were comparable to those ofother graft techniques. MCST showed more stable results in anterior perforation than in underlaygraft.