Introduction: Perforations of the tympanic membrane are a feature seen commonly in chronic otitis media (COM). It results in the reduction in the vibrating area of the tympanic membrane. This can lead to conductive hearing loss up to 40–45 dB. Thus tympanic membrane perforations can be disturbing functionally and psychologically to patients. Aim: Our aim was to measure the outcome of patients who underwent tympanoplasty for mucosal type of chronic otitis media (COM) using Middle ear risk index (MERI) score. Materials and Methods: This study was conducted in the Department of Otorhinolaryngology, at a tertiary health care centre from March to July 2019 as a pilot study. We observed the outcomes of tympanoplasty with the Middle Ear Risk Index (MERI) score. A total number of 62 patients were included in this study. Patients diagnosed with COM mucosal disease underwent pre–operative oto–microscopic examination and PTA taken at speech frequencies and MERI score was calculated. Patients were classified as normal, mild, moderate or severe MERI group based on the score. Results: Patients with a high MERI score had lower rate of graft uptake, whereas, patients with mild MERI had greater hearing benefit and those with severe MERI had lesser hearing benefit postoperative. Conclusion: MERI score helps to predict the outcome of tympanoplasty. It has an inverse relation with graft uptake and hearing benefit. Based on MERI score, the chances for surgical success and hearing benefit could be explained to the patient.