Objective: Etiology and pathogenesis of tympanosclerosis is still unclear. Risk factors for atherosclerosis have been well known and guided in preventing strategies for reducing cardiovascular disease prevalence. The probable association of atherosclerosis with tympanosclerosis may open a new frontier in reducing tympanosclerosis development and related hearing loss. The purpose of the present study was to evaluate association of some of the commonly accepted risk factors for atherosclerosis with tympanosclerotic patients. Materials and Methods: Fifty patients with tympanosclerosis and 50 patients without tympanosclerosis undergoing surgical treatment included in the study. Of the risk factors commonly accepted for atherosclerosis, positive family history for cardiovascular disease (CVD), high density lipoproteine (HDL), low density lipoproteine (LDL), cholesterol, high sensitive C-reactive proteine (CRP) and homocysteine levels determined and compared between tympanosclerotic and non-tympanosclerotic groups. Results: Only high homocysteine levels were found statistically significant in tympanosclerotic patients (p<0.05). A positive family history for cardiovascular disease was found at a rate of 18/50 in patients with tympanosclerosis and 10/50 in patients without tympanosclerosis. Conclusions: High homocysteine levels which was shown as a risk factor in atherosclerosis in many reports, were found also as a risk factor in patients with tympanosclerosis. Copyright 2005 © The Mediterranean Society of Otology and Audiology.