Over the past 10 years a variety of acquired external auditory canal pathologies have been treated at the University of Virginia. Surgical intervention has been required in 16 patients (18 ears). The most common diagnosis in this group was canal stenosis. Split-thickness skin grafts have been used for epithelial coverage. Depending on the size and location of the canal defect, one of three graft types was used: island, segmental, or circumferential. Surgical techniques are discussed and illustrative cases presented. Long-term graft results have been excellent, with no patient requiring a second graft for coverage. In those patients with preoperative conductive losses, the average improvement in hearing threshold was 27 decibels.