Objective To investigate the clinical effect of tragus cartilage-perichondrium repair under otoendoscope in the treatment of tympanic membrane perforation. Methods A total of 78 patients with tympanic membrane perforation admitted to Guangyuan Central Hospital from 2020 to 2022 were selected as the research objects and divided into control group (n=39) and observation group (n=39) by random number table method. The control group received temporalis fascia tympanic membrane repair under microscope tube, and the observation group received tragus cartilage-perichondrium tympanic membrane repair under otoendoscope. The clinical treatment effect and postoperative adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 94.87%, which was higher than 82.05% in the control group (P<0.05). The incidence of postoperative adverse reactions in the observation group was 5.13%, which was lower than 17.95% in the control group (P<0.05). Conclusion The treatment of tympanic membrane perforation with tragus cartilage-perichondrium repair under otoendoscope can reduce the adverse reactions in patients with tympanic membrane perforation, and obtain a higher effective rate, which is worthy of clinical promotion.