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Objectives: To evaluate the clinical outcomes of surgical management of ear keloids in a 50-case series. To classify the Keloids into subtypes for better understanding of the different types of earlobe keloids To assess recurrence rates and complications following ear keloid excision. To analyze the effectiveness of surgical techniques and adjunctive measures in ear keloid management. Introduction: Ear keloids are a common fibroproliferative condition and pose significant cosmetic and psychosocial concerns. Management remains challenging due to unpredictable behavior and high recurrence rates. Multimodal approach with surgical excision remains a key treatment for well-established lesions. However, success depends on appropriate patient selection, meticulous technique, and adjunctive postoperative measures. This presentation describes our experience with surgical management of ear keloids in 50 cases, analyzing outcomes, complications, and approaches to optimize results. Materials / method: This descriptive observational study included 50 consecutive patients with ear keloids. A detailed clinical assessment was performed, documenting lesion characteristics, duration, and previous treatments. All patients underwent surgical excision under appropriate anesthesia, with technique tailored to the size and location of the keloid and ensuring tension-free closure. Postoperatively, all patients received intralesional triamcinolone injections and pressure dressing as adjunctive therapy. Patients were followed up at regular intervals to evaluate wound healing, complications, and recurrence Results: Among the 50 patients treated, satisfactory to excellent cosmetic outcomes were achieved in 84% of cases. Good wound healing without significant complications was observed in 90% of patients. Recurrence occurred in 12% of cases during follow-up. Postoperative intralesional triamcinolone and pressure dressing were well tolerated, with minor, transient adverse effects noted in 8% of patients. Conclusion: Surgical excision continues to be the cornerstone of management for established lesions, yet alone its often associated with unsatisfactory outcomes and recurrence rates . In this series, meticulous surgical excision with tension-free closure combined with structured postoperative adjuvant therapy formed the basis of treatment. Our findings provide practical guidance for clinicians and reinforce the role of combined modality therapy as the standard of care in ear keloid management.