Objectives: This study aims to compare the graft success and hearing results of the palisade and island cartilage graft, with a new wheel-shaped composite cartilage graft for type 1 tympanoplasty. Design: The study was designed retrospectively. Setting: The study was conducted at Katip Celebi University, Ataturk Training and Research Hospital, Otolaryngology-Head & Neck Surgery Clinic. Participants: Only patients with conductive hearing loss and simple pars tensa perforation of the tympanic membrane were included in the study. Main outcome measures: Pure tone average (PTA), air-bone gap gain (ABG), word recognition score (WRS), ABG closure and grafts success were compared between the graft groups. Results: Records of 111 patients were analyzed. The graft success rate was 89.7% for palisade cartilage graft (PCG, n= 39), 86.1% for island cartilage graft (ICG, n=36), and 97.2% for wheel-shaped composite cartilage graft (WsCCG, n= 36) (p=0.244). Average postoperative PTA and ABG values were significantly affected by the cartilage graft type, but WRS was not affected. (p = 0.005, 0.019, 0.306, respectively, One Way-Anova test). Post-Hoc LSD test showed a statistically significant decrease in PTA and ABG averages for WsCCG group compared to the ICG group (p= 0.004; CI%95= 15.1-2.2 dB and p= 0.023; CI%95= 8.2-0.4 dB, respectively). Postoperative PTA and ABG averages for WsCCG and PCG groups were similar (p= 0.069 and p=0.053, respectively). In addition, while there were 2 (5.1%) retractions in the PCG group and 1 (2.7%)in the ICG group, there was no retraction in the WsCCG group. Conclusion: The WsCCG provided comparable results with classical reliable graft techniques (PCG and ICG) and may recommend as a more suitable graft due to hearing results and resistance against retraction.