Microtia is a congenital condition characterized by a spectrum of ear malformations, ranging from minor structural anomalies to anotia. The etiology is multifactorial, with interplay of genetic and environmental factors being implicated. Early multidisciplinary involvement should include pediatrics, plastic surgery, otolaryngology, audiology, and speech pathology, to ensure that the child is appropriately supported as they grow. This article provides an overview of the condition, a brief historic review, and illustrated descriptions of 2 common surgical approaches: porous polyethylene reconstruction with a temporoparietal fascia flap, and autologous reconstruction in 2 stages following Firmin’s modifications of the Nagata technique.