The objective of this study was to evaluate the role of removing middle ear paragangliomas using an ultrasonic aspirator (UA) through a transcanal, exclusively endoscopic approach. Three consecutive patients undergoing transcanal endoscopic resection of middle ear paragangliomas using an UA were retrospectively studied. The primary outcome measure was achieving gross total tumor resection. Secondary outcomes included postoperative hearing and early convalescence. Two glomus tympanicum tumors and one small glomus jugulare were included, and complete tumor resection was achieved endoscopically in all cases. All patients demonstrated intact tympanic membranes and normal facial nerve function at the initial postoperative visit. There were no cases of bone-conduction pure tone threshold increases of more than 15 dB. The UA was helpful when performing exclusively endoscopic transcanal resection of middle ear paraganglioma given its simultaneous suction-aspiration capability.