The objective of this study was to assess the use of KTP laser in cholesteatoma surgery with regard to the rate of recurrence and preservation of the ossicular chain. This involved a retrospective analysis of cases of combined approach tympanoplasty surgery over an 8 year period. Two patients out of 13 (15%) who did not have laser used in the first stage developed recurrence observed at the second stage. Two patients out of 32 (6%) in whom the laser was used developed recurrence. The results for preservation of the ossicular chain with the use of laser in the first stage are less convincing. However, laser can be used in middle ear surgery to effectively eradicate residual cholesteatoma and potentially reduce recurrence rates.