Aim: To evaluate and compare the rate of cholesteatoma recurrence after Atticotomy surgery to that after Canal Wall Up Mastoidectomy (CWU). Material and Methods: The study involved 57 patients admitted to the ENT Department Almoassat Hospital. Atticotomy was performed in 30 cases, whilst CWU mastoidectomy within 27 cases. Follow up period was extended for two years to compare the symptoms and the necessity for second Ossiculoplasty surgery. Results: The recurrence rate was 23.33 % within atticotomy group, whilst it was 22.21 % in CWU group. CWU mastoidectomy showed better outputs in diffused cholesteatoma cases. Conclusion: A limited cystic cholesteatoma can be treated effectively by atticotomy, however CWU mastoidectomy remains the favorable technique to manage a diffused cholesteatoma.