ABSTRACTSixty-eight cases of congenital conductive hearing loss due to ossicular abnormalities were reviewed. The clinical and surgical details of each case were documented, and a classification was drawn up on the basis of the abnormalities encountered. Sixty-six percent of the cases were documented as middle ear anomalies in the absence of any other evidence of congenital disease. Improved hearing was obtained in 47% of those cases where corrective surgery was undertaken. Treatment and results are reviewed. The pattern of ossicular abnormality encountered in this series suggests a variable origin of the incus, either from first branchial arch alone or from both first and second branchial arches.