Objectives: To evaluate the presence of cartilage in the lateral nasal ala (LNA) via histological analysis of alar Mohs surgical specimens. An accurate understanding of nasal anatomy is essential to optimize esthetic and reconstructive surgical outcomes. LNA anatomy is typically pictured to include discreet accessory and sesamoid cartilages; however, the authors debate the actual presence of these structures. Methods: A blinded reviewer analyzed 101 lateral nasal alar histologic specimens from 362 tissue blocks using a Hematoxylin and Eosin (H&E) stain to assess for the presence of cartilage. Results: Out of the 362 tissue blocks histologically analyzed, only 1 included cartilaginous components. Conclusions: We conclude that the presence of sesamoid and accessory cartilages in the LNA within our sample set is exceedingly rare.