Thirty-four patients with tumors in the conchal bowl were treated with Mohs micrographic surgery. Twenty-six patients had basal cell carcinoma and 8 patients had squamous cell carcinoma. Thirty-three of 34 patients achieved a tumor-free margin during initial therapy. All patients remain free of recurrence and metastasis at an average follow-up period of 2.9 years. Thirty-three of 34 patients were allowed to heal by second intention. Only one patient required reconstruction to avoid stenosis of the external auditory canal.