We encountered 21 cases of congenital ear lobe anomalies at our clinic during the past seven years. This report presents our system for classification of these cases and describes some typical cases. We divided ear lobe anomalies into four groups according to the type of lobe as follows; large, adhesive, defective and cleft ear lobe type. In the large lobe type, the ear lobe is characteristically large. For the adhesive lobe type, no angle is formed between the ear lobe and the face, i.e. the helix is elongated in a straight line towards the face. The cleft ear lobe type is classified into two surgical categories, viz. the cleft and appendage types. The former is recognized by a cleft on the lobe which continues from the helix, whereas the latter type has an appendage on the lobe. Combinations of these two types are included in the cleft type because a cleft in the lobe is more significant in terms of the shape of the repaired ear lobe. As regards the surgical repair of these anomalies, careful consideration is required in order to accomplish tridimensional reconstruction and create the natural curve of the lobe using z-plasty and other local flaps.