Microtia and congenital aural atresia (CAA) are congenital anomalies that are so common that every otolaryngologist should be familiar with the initial evaluation and care of the patient. When one ear hears normally, speech and language development should be normal. The gross and fine motor development of the baby or child is not expected to be affected in isolated cases of microtia and CAA. Current technologies allow for reconstruction or habilitation of the microtic ear when the child is several years of age. The hope is that tissue engineering can eliminate donor site morbidity. Temporary prosthetic ears will remain an option. Aural atresia work continues to be very dependent on the patient anatomy and the need or desire for better hearing in the affected ear.