목적: Endoscope is good at finding the lesion in narrow field by the wider view angle. But endoscope should be grasped by left hand and the other hand is only available to manipulate instruments, So the endoscopic assisted surgery is usually the one handed surgery. Moreover, endoscope-assisted surgery is not easy method in the bleeding situation, because the bleeding could screen the surgical field. 방법:We designed the study for availability of endoscope-assisted surgery in the relatively less bleeding surgery as operation of congenital cholesteatoma in the children. The paitents were enrolled from Jan, 2013 to Dec, 2014 결과:The enrolled patients were 9 patients (five male, one female). And the average age of patients were 3.5 years. Cholesteatoma was located at ant portion of tympanic membrane in 4 patients, and post portion in 1 patients. Cholesteatoma of all cases were fully removed by endoscope-assisted surgery and the we confirmed no remnant was remained by the endoscopic view. Surgical complication as vertigo, worsening of hearing, infection, bleeding were not seen in the patients postoperatively. All patients were discharged from hospital at 1 day after surgery. After follow up, 4 patients have the normal hearing except one with posterior cholesteatoma. 결론:In summary, the the results were favorable, so we recommend the endoscopic approach as one of options of surgical route.