We conducted a prospective study to assess the effectiveness of a platelet-rich plasma hourglass graft in the repair of small tympanic membrane perforations as an office-based procedure. Our study population was made up of 25 patients-10 men and 15 women, aged 19 to 45 years (mean: 30.4 ± 7.2)-who each underwent repair of one eardrum. After administration of topical anesthesia, a single piece of platelet-rich plasma approximately double the size of the perforation was obtained from each patient's intravenous blood sample. After the margin of the perforation was freshened, the platelet-rich plasma was placed in an hourglass configuration, with equal portions lying medial and lateral to the perforation. Successful perforation repair was achieved in 21 of the 25 ears (84%). No patient developed an infection, hearing impairment, tinnitus, vertigo, bleeding, taste disturbance, or hyperkeratosis. We conclude that office-based platelet-rich plasma myringoplasty is a safe and effective minimally invasive procedure that is suitable for repairing small tympanic membrane perforations.