Objective: To study the outcome of mastoid cavity obliterations where inferiorly pedicled periosteal-pericranial flaps were used.Study Design: A prospective longitudinal study with a minimum follow-up of 18 months.Methods and Materials: Between 2004 and 2009, 63 mastoid cavity obliterations were performed on 59 patients. Of these, 24 were revision surgery and the remainder were primary surgeries. All the patients underwent open cavity tympanomastoidectomy, where the mastoid cavity was obliterated with inferiorly pedicled periosteal-pericranial flap and bone pate.Results: A total of 63 consecutive ears underwent open cavity tympanomastodectomy with mastoid obliteration; 55 (87%) had a very small dry healthy mastoid cavity, five ears (8%) had occasional otorrhea, which was relatively easily managed by topical therapy, and three ears (5%) had small granulation tissue that was treated with silver nitrate.Conclusion: Obliteration using the inferiorly pedicled periosteal-pericranial flap and bone pate is an effective method to manage patients with pre-existing cavities and also those not previously operated.