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Objectives The study evaluates the hearing result, complication rate and parental satisfaction following two different approaches in the management of external auditory canal atresia. Methods A retrospective chart review of 30 patients with external auditory canal atresia was conducted. Twenty of them underwent external canal atresia surgery and 10 had Bone Anchored Hearing Aid ( BAHA ). Hearing results, pre- and post-intervention, complications, parental satisfaction rate and speech improvement were measured. Results Closure of the air-bone gap (ABG) to 30 dB was seen in less than 50% in the surgery group. The BAHA group had closure of the ABG to less than 15 dB. Parental satisfaction was higher in BAHA group. The most common complications in the surgical and BAHA groups were group was soft tissue stenosis and adverse skin reactions for the BAHA group. Conclusion In the treatment of auditory canal atresia, BAHA provides superior hearing results, greater parental satisfaction and fewer complications as compared to surgery.