The success rate of tympanoplasty for the management of Chronic Suppurative Otitis Media (CSOM) ranges from 35% to 92%. A number of factors, such as age of patient, size and site of perforation, status of ear, ossicular status and surgical technique influence the success rate. The objective of this study was to assess the prognostic value of MERI in predicting the outcome of tympanoplasty in CSOM. A prospective observational study was conducted in 50 patients over a period of 1 year. The subjects were all cases of CSOM in the age group of 18-55 years with conductive hearing loss who underwent tympanoplasty with or without cortical mastoidectomy. The role of MERI was analysed as a prognostic indicator. Successful graft uptake was seen in 92% cases (n = 46). Of these 46 cases, 32 had mild MERI score, 10 had moderate MERI score and 4 had severe MERI score. It was observed that higher MERI score correlated with lower rate of graft uptake. Our study comprised of 50 patients of safe CSOM who were categorized into mild, moderate and severe on the basis of pre-operative MERI score. All patients underwent tympanoplasty with or without cortical mastoidectomy and the surgical outcome in terms of graft uptake was found to be significant. Higher the MERI score, lower was the graft uptake rate, whereas lower the MERI score, higher incidence of graft uptake was seen. Thus, preoperative MERI can be a useful tool to ascertain the prognosis of tympanoplasty.