Tympanomastoid paragangliomas (glomus tympanicum) are benign, vascular tumors arising along cranial nerves IX and X branches in the middle ear. Surgical excision, often guided by tumor classification and location, is the standard treatment; however, large tumors may be managed with radiotherapy as an alternative approach. This article details a MIS transcanal microscopic approach using a KTP laser to coagulate and remove the glomus tympanicum in a 61-year-old patient presenting with pulsatile tinnitus. The laser’s hemoglobin absorption optimizes hemostasis, minimizing bleeding and preserving surrounding structures. This technique offers promising outcomes with reduced morbidity but requires specific surgical expertise for safe application.