Fat myringoplasty is a simple office technique for repairing tympanic membrane perforations. It involves wedging a piece of fat from the ear lobule into the perforation. A search of the literature failed to reveal any controlled studies on the efficacy of this method, which may allow patients to avoid more invasive procedures. Controlled perforations in guinea pig tympanic membranes were treated with fat myringoplasties, paper patches, or no intervention. Four weeks following the procedures, ears were examined and photographed under the microscope and studied histologically. The fat myringoplasty healing rate exceeded the rates of both the control and paper-patch groups. Results were stratified with respect to location and size of perforations. The results and histological studies suggest that controlled studies in humans are warranted.