Objective : To determine between autologous cartilage and Teflon, the one which gives the better results of ossiculoplasty, in terms of increase in hearing sensitivity, acceptability and cost effectiveness. This is a randomized prospective study with 6 months follow up. 40 patients of CSOM were randomly assigned for ossiculoplasty using Teflon and cartilage (20 in each group).Surgical outcome was compared in terms of increase in hearing sensitivity, extrusion rate and cost effectiveness. Results: Mean hearing gain (closure in A–B gap) was 22.35±6.69 dB in cartilage and 20.35±6.67 dB in Teflon. Extrusion rate was 2 and 1 for Teflon and cartilage respectively. Conclusion: The study concluded that there is no significant difference in improvement in AB gap and extrusion rate though cartilage is slightly better. The only significant difference between the two groups was the cost effectiveness as the autologous material requires no extra cost so it can be considered as a preferred choice of implant, in comparison to biomaterial in SAARC countries, where the majority is of poor patients.