Objective To investigate the surgical efficacy of the postauricular subcutaneous pedicle flap in one stage reconstruction of retroauricula defect. Methods From September 2011 to September 2013, 16 cases with retroauricula defects were repaired by the postauricular subcutaneous pedicle flap in one stage reconstruction. The maximum size of defect was 2.2 cm×2.5 cm, and the minimum was 1.0 cm×1.5 cm. The surgical efficacy was observed after operation. Results All the postauricular flaps were survived postoperatively, and the auricular appearances of all the patients were satisfactory without visible scar during 2 to 12 months ’ follow up. Conclusion Postauricular subcutaneous pedicle flap, with reliable blood supply, similar contour, color, texture with surrounding tissue, and hidden donor site, is one of the best methods for the reconstruction of preauricular defects.