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Basal cell carcinoma is a common, slowly growing, locally aggressive, and rarely metastatic skin cancer. Primary BCCs of the external auditory canal are extremely rare. A 67-year-old patient presented chronic otitis media associated with a mass in the concha and the external auditory canal of the left ear. The patient was diagnosed with basal cell carcinoma of the EAC. Locoregional assessment on a CT scan revealed thickening of soft tissues in the external left auricle and external auditory canal. She underwent surgery. Given the insufficient margins, adjuvant radiotherapy was indicated. Radiotherapy was performed with the intensity-modulated radiation therapy technique in order to the overcome anatomical complexity of the region, cover the tumor bed, and preserve the organs at risk. BCC of the EAC is a rare and challenging entity, whose management is multidisciplinary. The main goal is to avoid local recurrence, as well as to improve the patient’s quality of life.