CONCLUSIONS Isolated congenital ossicular anomalies are diverse. Our proposed modified Teunissen and Cremers classification will be helpful for the evaluation of congenital ossicular anomalies as well as the prediction of surgical outcome. OBJECTIVE The aim of this study was to describe isolated congenital ossicular anomalies encountered in patients who have normal eardrums and to evaluate their surgical outcome based on their classification. METHODS A total of 78 patients (94 ears) with congenital ossicular anomalies were reviewed. The preoperative and postoperative audiological findings, surgical findings, and temporal bone CT results were analyzed. RESULTS Twenty-one types of ossicular anomalies were identified in this study. A stapes footplate fixation was the most common anomaly and this was usually bilateral. However, the anomalies that were associated with the incus and malleus were usually unilateral. The congenital ossicular anomalies were classified into five types according to the status of the stapes footplate. Using this modification of a prior classification system, the more severe anomalies of the stapes footplate could be identified, and the worst postoperative hearing result could be predicted.