Successful microvascular ear replantation is well described, and often involves the use of arterial inflow anastomoses with leeches and systemic anticoagulation to augment outflow. Failed replantation attempts have also been published, with most of the failures attributed to venous drainage problems. A case of successful replantation of an ear is presented using a single 0.5-mm arteriovenous anastomosis, as no suitable artery could be identified in the amputated part. Postoperatively, dextran and leech therapies were employed to promote adequate venous drainage. We report a 100% successful ear replantation using a single arterialized vein as the inflow. In situations where no adequate artery is identifiable in the amputated part, an arteriovenous anastomosis may be a suitable alternative.