‘In the ear’ headphones are held in position by the cartilaginous skeleton of the pinna. The tragus is an important part of this skeleton and plays a significant role in holding these devices in place. We designed a retrospective case–control study to determine whether the harvesting of tragal cartilage had any effect on the ability to wear ‘in the ear’ earphones. Fifty patients who had undergone ear surgery requiring harvesting of tragal cartilage, along with 50 age-matched controls who had undergone similar procedures without tragal cartilage harvesting, were sent a questionnaire about their experiences with ‘in the ear’ earphones both pre- and post-operatively. Ten of the 12 patients in the tragal harvesting group who had used earphones pre- and post-operatively had had problems with earphones post-operatively, which in eight cases were due to pain or the devices falling out. Of the 12 respondents in the non-tragus group, only one had similar problems (p<0.05). Tragal harvesting may affect the ability of patients to wear certain types of headphones post-operatively and this should be discussed pre-operatively with the patient.