Surgical management of congenital aural atersia is tried for the purpose of hearing gain with normal sound conducting system cosmetic improvement. We planned this study to review the clinical manifestations of congenital aural atresia and to evaluate the results of surgical treatment. The authors analyzed fifteen cases of congenital aural atresia who were managed surgically form January 1990 to January 1996 at Asan Medical Center. Male to female ratio was 8 : 7. The age ranged from 5 to 55 years with the mean age of 18.7 years, and all the 15 cases were unilateral. Eleven cases(73%) showed the auricle anomaly, and by Marx's classification, grade I was 6, grade II was 5 cases. According to the Schuknecht's classification of external auditory canal anomaly, A type was 1, B type was 6, and C type was 8 cases. The operations were done all by anterior approaches. Canaloplasty was performed in 14(93%) cases, skin graft was done in 10(67%) cases and ossiculoplasty was done in 5(33%) cases. Six cases(40%) of facial nerve anomaly were found. Preoperative pure tone average(PTA) in air conduction was 62dB and air-bone gap(ABG) was 50dB. In the follow-up audiometry in 13(87%) patients, postoperative PTA was 42dB and average ABG was 31dB. The averaged hearing gain was 20dB in air conduction and 19dB in ABG. The duration of postoperative follow-up ranged from 2 to 21 months and the mean was 6.7 months. There were 3 cases(20%) of postoperative complication. There was no specific difference in the hearing results according to the types of external auditory canal, but there was a tendency to increase in hearing gain in the ossiculoplasty-group than in the tympanoplasty-group.