Aim: To report a rare congenital anomaly of the external ear.
Background: Pinna or the external ear is the branchial apparatus derivative which may be anomalous due to error in embryological development many such anomalies are reported as anotia, microtia, preauricular sinus or cysts, tags, bat ear, etc. double pinna or the mirror image pinna is one such anomaly as others it may or may not be associated with syndromes.
Case description: A 9-year-old boy presented with left ear mirror image pinna and right ear preauricular tag had no other complaints. On systemic examination, no abnormality was detected. The patient was advised surgery which was deferred by the patient for time being.
Conclusion: Mirror image pinna is a rare congenital malformation which may or may not be associated with any syndromes. Surgical correction is possible which is done usually at age of 5–6 years.
Clinical significance: To know the rare congenital malformation, its probable embryological cause, associated features, and its correction.