Background <p>Ossicular discontinuity is a common cause of conductive hearing loss in chronic otitis media, most frequently involving erosion of the long process of incus. Restoration of ossicular continuity is essential to re-establish the middle ear transformer mechanism. While several materials have been described for ossiculoplasty, an ideal material that is cost-effective, biocompatible, stable, and easily applicable continues to be sought. Glass ionomer cement (GIC), widely used in dentistry, has recently gained attention for incudostapedial reconstruction in cases with small ossicular gaps.</p> Methods <p>This observational follow-up study included patients with chronic otitis media undergoing tympanoplasty who were intraoperatively found to have incudostapedial discontinuity of ≤ 2&#xa0;mm. Glass ionomer cement was used to bridge the defect and restore ossicular continuity. Pure tone audiometry was performed preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. Outcomes assessed included improvement in pure tone average (PTA), air-bone gap (ABG), graft uptake, and procedure-related complications.</p> Results <p>Sixteen patients were included in the final analysis. A statistically significant improvement was observed in mean PTA and ABG at all postoperative follow-up intervals compared to preoperative values, as assessed by repeated measures ANOVA&#xa0;(<i>p</i> &lt; 0.05). Most patients achieved postoperative ABG closure to within 20 dB. No major intraoperative or postoperative complications related to glass ionomer cement were encountered during the follow-up period.</p> Conclusion <p>Glass ionomer cement is a safe, effective, and economical material for incudostapedial reconstruction in selected cases with small ossicular defects. It allows physiological restoration of ossicular continuity and provides satisfactory hearing outcomes, making it a valuable alternative in resource-limited settings.</p>