Prominent ear deformity, affecting up to 5% of the white population, is characterized by an absent antihelical fold and conchal cartilage hypertrophy. These anatomical changes can potentially alter auditory function, including speech intelligibility in noise. To evaluate changes in auditory function, particularly speech intelligibility in noise, following otoplasty for prominent ear deformities. This prospective study included 25 patients undergoing otoplasty from January 2018 to December 2023. Audiometric evaluations, including pure-tone audiometry, tympanometry, and speech intelligibility scores (SIS), were conducted preoperatively and three months postoperatively at different signal-to-noise ratios (SNRs) and noise orientations. Preoperative SIS was significantly reduced at a -5 dB SNR with posterior noise, suggesting a pinna shielding effect. Postoperative evaluations showed no significant changes in pure-tone averages or speech discrimination scores. Otoplasty does not impair auditory function but may alter sound directionality in noisy environments, highlighting the need for further research.