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The persistent Stapedial Artery is a congenital variant of vascular type which is very rare and may present as a mass pulsating in the middle ear. Awareness of this variant is important as it may complicate middle ear surgery e.g. myringotomy or stapes surgery. We present a case of 28 years old lady who visited the ENT OPD with complaints of impaired hearing and tinnitus on left side. On physical examination subtotal perforation of tympanic membrane was noted without ear discharge. Pure tone audiometry revealed moderate conductive deafness on left side. Otomicroscopic examination revealed a persistent stapedial artery coursing between the posterior and the anterior crus of the stapes, which was well visualized through the perforation. The tympanic membrane of the patient was surgically repaired without any complication.
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