Prominent ear deformity is the most common abnormality of the external ear. Over two hundred different techniques have been described to correct this deformity. Many of these techniques have proven successful in their ability to achieve high patient satisfaction despite the significant variations in these techniques. From this perspective otoplasty is a privileged procedure allowing the surgeon great latitude in his approach and ability to achieve patient satisfaction. Despite high patient satisfaction, each technique has inherent strengths and weaknesses. The art of otoplasty is in the ability to realize the strengths and weaknesses of a cadre of procedures so as to maximize benefit and minimize complication. Analysis and correction of prominent ears should be approached in a rational, step-wise fashion. The external ear is an infinitely complex structure with great variation between individuals and between the two sides of the same individual. Appropriate evaluation is essential to the application of the appropriate corrective technique. Our approach to otoplasty includes a careful evaluation and description of the deformity in the context of normative standards and the goal of symmetry. When the patient is judged to be sufficiently mature we proceed with an algorithmic application of cartilage-sparing techniques suited to the specific deformity. In this approach, correction of the prominent ear can go beyond patient satisfaction, maximizing outcome in form and symmetry.