<p>Chronic suppurative otitis media (CSOM), particularly its inactive mucosal variety, is a prevalent otological condition characterized by persistent tympanic membrane perforation and conductive hearing loss. Type 1 tympanoplasty is a standard surgical approach for tympanic membrane reconstruction using temporalis fascia, valued for its biocompatibility and favourable acoustic properties. Platelet-rich plasma (PRP) rich in growth factors such as PDGF, TGF-β, VEGF and EGF has recently gained attention in otological surgeries. To compare the efficacy of autologous PRP with temporalis fascia versus Temporalis fascia alone in Type 1 tympanoplasty in terms of graft uptake and audiological outcomes. A total of 138 patients with inactive mucosal CSOM were randomized into two groups: Group A (<i>n</i> = 69) underwent tympanoplasty using temporalis fascia with PRP, while Group B (<i>n</i> = 69) underwent tympanoplasty with temporalis fascia alone. Postoperative outcomes were evaluated in terms of graft uptake and hearing improvement (Air-Bone Gap closure) at 1, 3 and 6 months. Graft uptake rates and hearing improvement were significantly higher in the group with temporalis fascia with PRP as compared to group with temporalis fascia alone at all follow-ups. No major complications were noted in either group. The adjunctive use of autologous PRP in type 1 tympanoplasty enhances graft uptake and facilitates superior auditory outcomes. Platelet rich plasma serves as a safe, cost-effective and biologically active scaffold in tympanic membrane reconstruction.</p>