Tympanoplsty is the common operation for chronic otitis media that is performed under local Anesthesia (LA) or general anesthesia (GA). LA is more popular than GA in the underdeveloped and developing countries in almost all ear surgeries. The authors have been using LA without sedation for more than 20 years. LA without sedation is relatively safer, less expensive and perform more surgeries in a shorter period of time. This study aimed to share the experience of LA without sedation in tympanoplsty. Patients and Method: 7050 patents underwent tympanoplsty under LA without sedation from 1999 to 2019 in the different hospital of Bangladesh. Patients were thoroughly evaluated preoperatively, explained the advantages of LA without sedation in details LA was used with different Adrenaline concentrations (1: 1000 to 1: 200,000) either by injection or topically. Patients’ compliance, pain, discomfort, drowsiness, and other parameters ware recorded. Results: Amongst 7050 patients, 3877 were male and 3173 were female. The youngest patient was 14 year boy and oldest patient was of 58 year male. Operative time was short with a bloodless field. Mean operative time was 45 minutes. The overall safety was good and needed shortest hospital stay (Hour/day); and of course very less expensive. Conclusion: Tympanoplsty under local anesthesia without sedation is safer, relatively cost effective, can be performed as a day/hour care case. Suitable patient selection and adequate preoperative counseling is essential to achieve a great success

Keywords : LA, no sedation, tympanoplsty, safe, less expensive.