Learning Objectives: Endaural approach can be performed through postauricular incision. Author has 20 years of experience using endaural approach in cholesteatoma surgery. Author will discuss the surgical technique, patient selection, difference in surgical drilling compared to corticol mastoidectomy, and results. Endaural approach allows minimally invasive surgery for cholesteatoma patients with fast recovery and smaller mastoid cavity for post operative care. Hearing results are competitive to corticol mastoidectomy results. Case selection is important but also surgery can easily swith into canal down procedure if the pathology is larger than predicted before surgery. Cartilage grafting is important part of the surgery and grafts material is usually optained from auricular concha rather than tragus.