Injuries to the ear can result in partial or complete loss of the external ear. Resection of the external ear may be necessary secondary to malignant tumor or infection. This article discusses the diagnosis and management of acquired defects of the external ear. Because autogenous reconstruction is not always possible, both autogenous and prosthetic reconstruction are presented as well as the indications for both. This information should help guide the clinician in the decision-making process. In the hands of experienced clinicians, reconstruction of the external ear can result in an excellent outcome, with improved quality of life for the patient. © 2013 Elsevier Inc.