In a retrospective chart review, we evaluated the surgical and hearing results of a single-stage procedure consisting of a canal-wall-up attico-mastoidectomy, mastoid cavity obliteration, scutum plasty, and ossiculoplasty. A total of 77 patients treated between March 2003 and January 2011 with postoperative follow-up of at least 60 months were enrolled. Preoperative and postoperative pure-tone average (PTA) and air-bone gap (ABG) were assessed and compared 1 and 5 years after surgery. At the final follow-up, the tympanic membrane was intact in 71 (92.2%) patients. Retraction pockets were found in 10 (13.0%) patients: with 9 (11.7%) in the pars tensa, 5 (6.5%) in the posterior tympanic sinus, and 2 (2.6%) in the attic region (some patients had multiple sites of retraction). Two (2.6%) patients developed recurrent cholesteatoma and underwent revision surgery. During the follow-up, 7 (9.1%) patients were found to have partial canal wall deformities; 5 (6.5%) were in the scutum region and 4 (5.2%) in the posterior canal wall. Long-term improvement and/or preservation of hearing were obtained in 55.8% of patients, and maintenance of PTA-ABG closure was within 20 dB. In conclusion, the hearing results and surgical outcomes of our single-stage procedure were satisfactory and similar to those in other reports. We conclude that our technique may be used as an alternative in the management of adult cholesteatoma.