Alar rim grafts date back to the 1950s for the correction of alar base in cleft lip nose. Cartilage struts under the anterior half of the alae of a pinched nose tip were popularised and the cartilage of the auricular concha became the donor site of choice for nasal procedures. Recently, some surgeons pointed to its potential role in aesthetic cases and added some technical refinements. These grafts are used for open and closed rhinoplasties. They usually consist of a rod of septal or auricular cartilage that we lay as reinforcement inside a pocket along the alar margin. Indications include the following: congenital or traumatic asymmetry, dynamic alar collapse, alar flare, primary retraction or notching, secondary (surgical or traumatic) retraction and malposition of the lateral cartilages (upwards or downwards). Harvesting and implanting techniques as well as the possible drawbacks are discussed.