To investigate the treatments and complications of the congenital aural atresia.Form 1996 to 2002, 446 ears with congenital aural atresia underwent operations in the Otolaryngology Department of the Tongren Hospital. During the follow up from 6 months to 5 years, 47 ears occurred postoperative complications, which can be divided into five groups: external acoustic pore stenosis, external auditory canal stenosis, hearing loss, facial nerve palsysis. The hearing results of these 43 ears showed 12 ears had a decrease of 10 dB, 19 ears of 20 dB, 12 ears of 30-40 dB.The causes of complications mainly were insufficient opening of bony external canal, secondary infection and lateral healing of the transplanted tympanic membrane, and the surgeon did not master the anatomic characters of the abnormal facial nerve. Forty-three ears received operation again, including 24 ears with external acoustic pore stenosis, 9 ears with external auditory canal stenosis, 8 ears with hearing loss and 1 ear with facial nerve palsysis. Hearing improvement was found in 43 ears (100%) in which 10 ears (23.3%) with improvement of 10-20 dB, 21 ears (48.8%) of 20-30 dB, 12 ears (27.9%) of 30-40 dB. The one ear with facial nerve palsysis recovered 2 months after operation.External auditory canal stenosis and lateral healing of the transplanted tympanic membrane are the primary causes of postoperative hearing loss. Do not injure the facial nerve for hearing improvement in cases of facial nerve abnormalities.