Objectives: To evaluate the effect of platelet rich fibrin in treating acute traumatic tympanic membrane perforation as regards wound healing and hearing outcome compared with conservative treatment. Methods: This study was conducted on 50 patients presented with acute traumatic tympanic membrane perforation classified randomly into 2 groups: the study group; (25 patients) treated with platelet rich fibrin membrane and control group; (25 patients) underwent conservative treatment. Patients were followed up for 6 weeks to assess healing rate of the tympanic membrane perforation and hearing improvement. Results: In the group where platelet rich fibrin was used, complete perforation closure occurred in 88% of patients, while in the group treated conservatively, closure was obtained in 56% (P 0.004). The mean air bone gap improved in the platelet rich fibrin-treated group from 18.83±3.99 dB to 3.38±4.13 dB and in the control group from 18.90±3.43 dB to 9.84±8.04 dB. The post-treatment mean air bone gap significantly improved better in the platelet rich fibrin-treated group than in the control group (P 0.004). Hearing gain by >10 dB was obtained in 88% of patients in the platelet rich fibrin group and in 44% of patients in the control group (P 0.001). Conclusion: In comparison with the conservative management, platelet rich fibrin, as an autologus simple graft method, provided more healing rates with better audiological outcomes with low cost and no complications.