This program is a comprehensive review of the developmental anatomy and physiology of the human ear canal along with an in depth review of the pathological conditions that would result in either an in-office intervention or a medical referral for intervention. Examining the ear canal should never be a quick “in-and-out” procedure. The human ear canal is a living system that is subject to a variety of pathologies other than cerumen accumulation or a foreign object. Foreign objects and cerumen are common identifications however draining ears, single or multiple growths, blood or other different or unusual findings require an immediate response and, in some cases immediate referral to a physician for intervention. The importance of a thorough case history is emphasized, especially if the patient is diabetic, has an auto-immune disease or is taking anti-coagulant medications that makes bleeding difficult to manage. The program is highlighted with the identification of over two dozen ear canal pathologies along with management strategies for each pathology. Also, there is a review of first aid procedures for bleeding during cerumen management. Finally, a case study is presented that involved a patient who passed out during otoscopy.