Objective This study aims to compare continuous irrigating mode for endoscopic ear surgery(CIM-EES)and traditional microscopic ear surgery(MES)for treating attic cholesteatoma.Methods 72 patients diagnosed with attic cholesteatoma admitted to the Department of Otolaryngology-Head and Neck Surgery,School of Clinical Med-icine,Yangzhou University from August 2021 to March 2022 were selected and divided into CIM-EES and MES groups by the random number table method.Patients in the CIM-EES group were treated with continuous irrigating mode endo-scopic surgery,and patients in the MES group were treated with transcanal microscopic surgery.The intraoperative mid-dle ear structural visibility index(MESVI),operative time,postoperative pain condition and surgical treatment effect were compared between the two groups.Results The intraoperative MESVI score of CIM-EES group was lower than that of MES group,the difference was statistically significant(P<0.001);the operative time was shorter than that of MES group,the difference was statistically significant(P<0.01);the postoperative pain score was lower than that of MES group,the difference was statistically significant(P<0.01);the surgical effect of the CIM-EES group was compared with that of the MES group,the differences were not statistically significant(P>0.05).Conclusion CIM-EES for treating attic cholesteatoma has substantial advantages over MES,including better intraoperative visualization,less intraoperative bone grinding,continuous clear intraoperative visualization,shorter operative time,less postoperative pain for patients,and lower incidence of postoperative complications.