Patients may present incidentally or with symptoms of wax impaction or recurrent otitis externa. Exostoses themselves rarely cause hearing loss. Most patients can be managed conservatively and the use of ear plugs is gaining increasing acceptance. Rarely surgical correction may be required. Various surgical approaches can and methods of bone removal can be used. In all cases however the emphasis must be on a careful consideration of the surrounding anatomy, meticulous preservation of the ear canal skin and attentive postoperative care if the risk of complications is to be minimised.