To report and evaluate the surgical outcomes of the treatment of attic cholesteatoma using epitympanoplasty with cartilage obliteration in the preservation of the posterior canal wall. Our study group consists of 138 subjects with attic cholesteatoma who underwent surgery of the mastoidectomy of the intact posterior canal wall and epitympanoplasty with cartilage obliteration, from November 2008 to November 2010. The major techniques employed included the following: (1) mastoidectomy with the preservation of the posterior canal; (2) removal of the scutum; (3) epitympanum obliteration with cartilage, and (4) mastoid obliteration with bone dust. The post-operative observation period was between 2 and 4 years. All patients were examined via microscopy and oto-endoscopy. Of these 138 subjects, 91 subjects have a follow up period of more than 3 years. There was no retraction pocket formation in the epitympanum in all cases. However, in two subjects, there was a recurrence of cholesteatoma within the mesotympanum. Other observable post-surgery complications were also recorded. For hearing results, 64 of the 138 subjects underwent post-operative audiometric testing for 2 to 3 years and 3 to 4 years consecutively. The average pre- and post-operative air-bone gap closure was found to be 11.97 ± 11.02 dB for the 2 to 3 year period, and 10.08 ± 10.34 dB for the 3 to 4 year period. Based on the results of our study group, epitympanoplasty with cartilage obliteration in the preservation of the posterior canal wall is a better alternative treatment technique for attic cholesteatoma.