Microvascular ear replantation is a rare event, having been reported only 25 times since the first case in 1980. It requires a lengthy operative time and hospital stay, results in multiple blood transfusions, and has a significant failure rate. Nevertheless, a successful ear replantation is a dramatic demonstration of the power of microsurgery to restore a lost part. When successful, it obviates the need for other complex reconstructive efforts and provides an unsurpassed aesthetic result. This article reviews the history of microsurgical and nonmicrosurgical ear replantation and presents recommendations for treatment.