Since newly developed antibiotics for gram negative organism, aural perichondritis is well respond to prompt treatment without deformity of an auricle. But necrosis of cartilage developed occasionally and gross deformity of auricle has resulted in spite of variable methods of treatment. Authors experienced 5 cases of perichondritis combined necrosis of cartilage and intensive surgical procedure which was early excision of skin, perichondrium and cartilage of infected region and secondary skin graft performed. The results were excellent with short duration of treatment and minimized external deformity. So we reported with review of literature.