The 2-stage Nagata method for auricular reconstruction in patients with microtia is a widely accepted technique. We have modified this technique into a single-stage procedure for the reconstruction of acquired segmental auricular defects. A prospective analysis was made of the senior author's first 20 consecutive cases over a 4-year period (February 2004 to February 2008). The mean age of patients in our series was 34 years (range, 17-59 years). There were 15 males and 5 females; 13 were right-sided and 7 were left-sided segmental auricular defects. Five patients had had previous auricular reconstruction including local flaps and grafts. Costal cartilage harvest was ipsilateral to the defect in all cases. All 20 patients underwent a single-stage modification of the Nagata technique. Mean duration of surgery was 8.56 hours (range, 5.5-11.5 hours). Mean hospital stay was 7.6 days (range, 4-19 days). Mean time from initial surgery to a satisfactory completion of treatment was 21 months. Overall, a low complication rate and high patient satisfaction were observed in this series. We believe the single-stage modified Nagata technique offers consistent high-quality results in the treatment of acquired segmental auricular defects. All patients undergoing autologus ear reconstruction need to be assessed in a multidisciplinary setting and should be offered all other options for treatment.