Background:Otosclerosis is one of the leading causes of conductive hearing loss with an intact tympanic membrane in adults. The stapedius tendon is routinely transected during stapes surgery. This study aimed to evaluate the success rates of stapedectomy with preservation of stapedial muscle tendon compared to stapedectomy without preservation of stapedial muscle tendon in the operative management of otosclerosis. Main text:This is a retrospective study. It was conducted in the Otorhinolaryngology Department, Faculty of Medicine, Zagazig University during the period from October 2018 to January 2021. The sample size is 36 cases were arranged into two groups the first group with preservation and the second group with cut of stapedial tendon and the size of each group is 18 cases. There was no significant difference between both groups in hearing improvement, but there was a significant difference between both groups in post-operative tinnitus improvement and acoustic reflex preservation. Conclusions: Preservation of the stapedial tendon in the surgical treatment of otosclerosis is associated with improvement in functional outcomes, as well as provide the patient with a stapedial reflex that had a primary protective effect against strong acoustic stimuli