Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign condition with initial symptoms of vascular nodules or papules that are pruritic and bleed easily. Despite the fact that these lesions most commonly are found in the head and neck region, especially the periauricular area, little is found in the otolaryngology literature on ALHE. The first case report was by Mendonca,' who described a "pseudopyogenic granuloma" of the ear. Several case reports have followed reporting involvement of the salivary glands,' oral mucosa,' and periauricular area." Barnes et a1. 9 reported a series of 12 cases of ALHE, 11 of which involved the periauricular region or scalp. Few of these cases have involved the external auditory canal (EAC),I,5,6,9 and multiple treatment modalities have been used, with no uniform treatment being agreed upon because of the rarity of these cases. We present three cases of ALHE with extensive involvement of the EAC and discuss the typical presentation, histopathologic characteristics, and treatment of patients with ALHE, particularly disease involving the EAC.