Objective: Despite continuous technical advancements, the basic optic principles and their limitations have remained the same over the past few decades. This study was aimed at visualizing and evaluating the middle ear structures with the help of otomicroscope and angled endoscopes in cases of chronic suppurative otitis media. Materials and methods: In this prospective study, 180 patients (200 ears) above the age of 18 years with CSOM were examined by otomicroscopy and otoendoscopy. The visualizations of middle ear structures were compared and statistically analyzed. Results: In all the parameters studied, endoscopy provided a significantly better visualization as compared to microscope. Zero degree was better than microscopy in visualization of round window niche, oval window niche and facial recess even though not statistically significant. 30 and 70 degrees provided good visualization of the round window niche, oval window niche, facial recess, sinus tympani, pyramid, stapedius tendon, long process of incus, incudostapedial joint, stapes suprastructure, eustachian tube opening, hypotympanum and fundus of retraction pockets. Conclusion: Otoendoscopy provides better visualization of all the middle ear structures as compared to otomicroscope. Endoscopy must therefore be more frequently used in the OPD setup, so that more and more cases can be rightly diagnosed thus preventing surprises for the operating surgeon.