introduction: Full thickness nasal ala defect is one of the most difficult problems for reconstructive surgeons.We experienced four cases of large nasal ala defect reconstructed using the free auricular flap.Patients and Methods: Free auricular flap using the root of ear helix has been transferred for nasal ala reconstruction in four cases.In three cases, unilateral nasal ala reconstruction was performed.In one case, bi-lateral nasal ala reconstruction was performed.In all cases, the flap has been elevated based on the reversed superficial temporal vessels.Furthermore, the residual superficial temporal vessels were also included in the flap.The facial artery and vein were used for recipient vessels in the nasolabial fold.In cases that the facial vein could not be found in the nasolabial fold, angular vein was detected around the medial canthus and used as a recipient vein.Result: In all cases, successful reconstruction was performed.Six months after the reconstruction, they showed acceptable shape of the nose.Conclusion: The advantage of the free auricular flap is that it has good color and texture match to the nasal skin.Furthermore, the free auricular flap from the root of ear helix can provide full thickness nasal ala reconstruction from only one donor site.Long vascular pedicle can be included by using the reversed superficial temporal vessels as donor vessels.In case that the facial vein can not be detected in nasolabial fold, angular vein around medial canthus can be used as a second choice for a recipient vein.We believe that this method can be good alternative option for full thickness nasal ala reconstruction.