Aim: To determine whether infants with isolated minor anomalies of the externa l ear are at increased risk of renal malformations. Methods: Consecutive infants with isolated minor anomalies of the external ear (preauricular skin tags, prea uricular sinuses, ear pits, and misshapen pinnae) were offered renal ultrasonogr aphy by experienced sonographers over a 41 month period. The prevalence of renal anomalies in such infants was compared with that detected on routine fetal scan ning during the same period. Results: Ninety six of 13 136 liveborn infants (7.3 /1000, 95%confidence interval (CI) 5.9 to 8.9) were noted to have isolated mino r ear anomalies on routine neonatal examination, with preauricular skin tags bei ng the most common (85%). Ninety one (95%) infants underwent renal sono- graphy at a mean (SD) age of 40 (19.0) days. Only one infant (1.1%, 95%CI 0. 03 to 5.9) had transient unilateral pyelectasia. During the same period, non-sy ndromic renal anomalies were found in 0.64%(95%CI 0.52 to 0.73) of infants, a prevalence no different from that of infants with minor ear anomalies (p = 0.44) . Conclusions: Routine renal imaging is not warranted in infants with such minor external ear anomalies unless accompanied by other systemic malformations. Methods: Consecutive infants with isolated minor anomalies of the external ear (preauricular skin tags, prea uricular sinuses, ear pits, and misshapen pinnae ) were offered renal ultrasonogr aphy by experienced sonographers over a 41 month period. The prevalence of renal anomalies in such infants was compared with that detected on routine fetal scan ning during the same period. Results: Ninety six of 13 136 liveborn infants (7.3 / 1000, 95% confidence interval (CI) 5.9 to 8.9) were noted to have isolated mino r ear anomalies on routine neonatal examination, with preauricular skin tags bei ng the most common (85%). Ninety one (95%) infants underwent renal Only one infant (1.1%, 95% CI 0. 03 to 5.9) had transient unilateral pyelectasia. During the same period, non-syndromic renal anomalies were found in 0.64% (95 % CI 0.52 to 0.73) of infants, a prevalence no different from that of infants with minor ear anomalies (p = 0.44). Conclusions: Routine renal imaging is not warranted in infants with such minor external ear anomalies unless accompanied by other systemic malformations.