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No restrictions on language, publication year, or publication status were applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>The meta\u2010analysis included data from articles that met inclusion criteria and were extracted by 2 authors independently. The PRISMA statement was followed. Risk of Bias 2.0 and Newcastle\u2010Ottawa Scale were used to assess risk of bias. The primary outcome was tympanic membrane closure rate. The secondary outcome was improvement of the air\u2010bone gap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten studies were included, 9 cohort studies and 1 randomized clinical trial, with 577 patients. The graft take rate was 82.8% in the butterfly cartilage inlay tympanoplasty group and 85.2% in the temporal fascia underlay tympanoplasty group (relative risk, 1.01; 95% CI, 0.93\u20101.11; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 42%, <jats:italic>P<\/jats:italic> =. 08). The air\u2010bone gap reduction ranged from 6.1 to 11.28\u00a0in the butterfly cartilage inlay group and from 5.2 to 12.66\u00a0in the temporal fascia underlay group, with a mean difference between groups of \u22122.08 (95% CI, \u22123.23 to \u22120.94; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 58%, <jats:italic>P<\/jats:italic> =. 04), favoring temporal fascia underlay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The 2 tympanoplasty techniques analyzed here produced similar results in terms of successful reconstruction of the tympanic membrane and reduction in the air\u2010bone gap. 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