Endoscopic Cholesteatoma Surgery has gained increasing acceptance for its minimally invasive transcanal approach, its intent to eradicate the disease while preserving the mastoid and its role in restoring a more physiological middle ear ventilation system. This course is intended as a comprehensive summary of two surgeons reviewing their ten years’ experience in endoscopic cholesteatoma surgery and critically analyzing their long-term clinical achievements as well as their limitations, complications, and clinical failures.