Otoplasty has a long history. Currently, two schools of thought predominate, which can be summarised as cartilage cutting and cartilage sparing techniques. The former includes removal of cartilage and the scoring of cartilage, whereas the latter involves contouring by placement of sutures. The authors present a brief review of early and late complications. Early complications include haematoma, infection or necrosis. One of the hallmark signs for all early complications is intense, one-sided pain. For late complications pathologic scar formation, recurrence of protrusion and a variety of technically based complications leading to deformities are addressed. Fortunately, complications after otoplasty are relatively uncommon. In order to obtain the best outcome the authors present the keys to successfully avoiding complications that might arise, based on a thorough understanding of their cause and how to manage complications successfully.