OBJECTIVE To report a surgical method for the treatment of pre-auricular fistula to lower post-operative recurrence rate. METHODS Clinical data of 187 patients with pre-auricular fistula who underwent en bloc resection at the Affiliated Hospital of Luzhou Medical College from August 2006 to November 2012 were retrospectively reviewed. Factors that might affect the prognosis following En bloc fistula resection bordered by the superficial temporalis fascia, helix perichondrium and auriculocephalic sulcus were investigated. RESULTS Of the 187 patients, 181 achieved primary healing and 6 ended up with delayed healing. During the follow-up period (one to seven years), there were 4 cases of recurrence (2.1%). CONCLUSIONS Clear demarcation of surgical resection can facilitate easy and thorough resection of preauricular fistula and lead to low recurrence rate. Proper timing and careful search for potential fistula branches are the two crucial factors affecting prognosis.