Introduction: Tympanosclerosis is a disorder associated with calcareous deposits in various parts of the middle ear. It is an irreversible end result of any unresolved specific or nonspecific inflammatory disease of the middle ear characterized by anatomical distortion resulting in conductive type of hearing loss.1 Objective: This study was conducted in a tertiary care teaching hospital to know the incidence, to study clinical features, histopathology and the quantum of hearing loss secondary to tympanosclerosis (TS) in cases with chronic otitis media (COM) undergoing surgical treatment. Methodology: All patients with chronic otitis media (COM), either mucosal or squamosal type undergoing surgery were included in the study. Results: Out of 160 cases operated for COM, 52 cases (32.5 percent) had tympanosclerotic plaques. In 52 cases with TS plaques, 5 cases (all are males) were squamosal type with histopathological evidence of cholesteatoma and rest 47 cases were of mucosal type (24 males & 23 females). On histopathological evaluation of the TS plaques, only 7 cases showed extensive hyalinization and the reminder showed fibrotic changes, granulation tissue, dense collagen, scattered fibroblasts and inflammatory cells. Conclusion: TS is a common association, clinically and pathologically with COM more with mucosal type. TS causes significant hearing loss compared to similar cases without TS. TS patches over critical areas like stapes foot plate, facial nerve canal and semicircular canals may be difficult to manage because of their strategic location.