Congenital aural atresia (CAA) is a birth defect that describes both aplasia and hypoplasia or stenosis of the external auditory canal (EAC). CAA can be associated with microtia (malformation of the pinna), middle ear and occasionally inner ear malformations. Surgical correction of CAA is a very challenging operation and requires a thorough knowledge of the surgical anatomy of the facial nerve, middle and inner ears. Traditional post-auricular approach or transcanal approach with the help of a microscope usually provides adequate images needed for the procedure. Endosocpic ear surgery provides the advantage of visualization beyond the view provided by the microscope, further refinement of the surgical approach, precise assessment of the ossicular chain mobility and placement of ossicular chain prosthesis if necessary.