Objective To investigate the application effect and manufacturing skills of autologous costal cartilage scaffold in ear reconstruction for microtia. Methods From January 2016 to January 2019, 41 patients with microtia reconstruction in our hospital were selected, all of whom were type Ⅱ or type Ⅲ pediatric deformities. All patients underwent auricle reconstruction and retroauricular skin expansion and autologous costal car-tilage stent. The first stage of the operation is to insert a skin dilator behind the residual ear and inject water to expand. The second stage of the operation is to carve and repair the soft ribs (usually 6 or 7 ribs) from the body, make a three-dimensional auricle support for auricle reconstruction, place a negative pressure drainage tube, and follow up for 3 to 6 months to observe the three-dimensional shape of the reconstructed auricle and the formation of cranio-auricular angle. Results 41 patients with microtia had good three-dimensional shape of auricle reconstruc-tion, normal auricle position, moderate cranioauricular angle, good helix and triangular fossa structure, and good bilateral symmetry. Patients and their families were satisfied with the ef-fect of auricle reconstruction. Conclusion Autologous costal cartilage is a good scaffold for auricle reconstruction. It is through efficient and elaborate carving and splicing that a good three-dimensional auricle structure can be formed. Combined with early flap expansion, a good postoperative appear-ance effect can be obtained, which is the appropriate method for auricle reconstruction at present.