Objective To explore the clinical application of remnant earlobe retrograde transposition in the ear reconstruction for microtia with severe low-set ear. Methods From January 2014 to December 2015, 20 cases of unilateral microtia with severe low-set ear were treated. Ear reconstruction was processed with expansion technique. A 50 mL kidney-shaped expander was implanted inside retroauricular region. Saline injection was carried out three times a week. It took one month to complete the saline injection. One month after expansion, ear reconstruction was carried out secondarily. The lower part of the ear remnant was incised to form an earlobe remnant flap, which was retrogradely transposed to reconstruct earlobe. The wound of ear remnant was sutured afterwards. Results No blood supply compromise occurred in 20 cases. All the patients were followed up for 6 months to 2 years, natural appearance and symmetry of bilateral earlobe position were gained. Conclusion In the cases of severe hemifacial microsomia with significant low-set ear, earlobe retrograde transposition can be used to correct the earlobe position and reconstruct earlobe with natural appearance and good symmetry with the other side.