Carcinomas of the external auditory canal are rare, nevertheless they are associated with a relatively poor prognosis. Among these tumours, basal cell carcinomas are less frequent than squamous cell carcinomas. Anyway, it is difficult to determine if their prognosis is better, as in other localizations on the body. We reviewed six patients, presenting locally advanced basal cell carcinomas of the external auditory canal and considered the history of their disease, the treatment procedures and final oncological outcome. Four of the patients died of the disease within five years from surgery. They presented local recurrences even after radical surgical excision in free tissue margins. From these findings we have the impression that basal cell carcinoma of the external auditory canal behave, even after radical surgery, as an aggressive tumour associated with a really poor prognosis.