Background Tympanic membrane (TM) perforations can arise from a variety of causes. Major causes include trauma and middle ear disease. Surgical treatment involves higher costs, more effort, and surgical risks. Therefore, many investigators have studied topical use of substances to facilitate TM repair. Estrogen can infl uence the various phases of wound healing in cutaneous repair. Topical estrogen application may infl uence the repair of TM perforations. Aim of the work The aim of the work was to evaluate a new procedure for repairing TM perforation and improving hearing threshold after 30 days using estrogen paper patch. Patients and methods After obtaining informed consent, patients were randomly allocated into two groups. One group was treated with estrogen paper patch (paper patch impinged with1% estrogen ointment to act as the study group), and the second group was treated with paper patch impinged with local antibiotic ointment to act as the control group (we used 1% tetracycline ointment in our study). Conclusion Perhaps, there is a signifi cant and promising result for estrogen paper patching as a method of repairing TM perforation.