AIM: Prominent ears are a common congenital deformity that can cause significant psychological distress, especially in school-age children. This study aims to evaluate the clinical and aesthetic outcomes of the ''inside-out'' otoplasty technique in addressing prominent ears in children aged 7 to 17. METHODS: A retrospective review was conducted on 20 children (5 boys, 15 girls) who underwent bilateral ''inside-out'' otoplasty. Postoperative outcomes were evaluated at one year using the Global Aesthetic Improvement Scale (GAIS) and Visual Analog Scale (VAS) to assess clinical success and parental satisfaction. The procedure focused on reshaping the ear cartilage internally and externally to form natural helical and antihelical folds. RESULTS: Among the 20 patients, 60 % were rated as "very much improved" on the GAIS scale, 30 % as "much improved," and 10 % as "improved." No cases of "no change" or "worse" were observed. Additionally, 95 % of parents reported being "very" or "completely" satisfied with the appearance and symmetry of their children's ears, reflecting a high level of aesthetic and clinical success. Visual Analog Scale (VAS) scores demonstrated significant satisfaction, with all patients scoring between 1 and 3, further confirming the positive clinical and psychological outcomes of the ''inside-out'' otoplasty technique. CONCLUSION: The "inside-out" otoplasty technique effectively corrects prominent ears in school-age children, providing aesthetic and psychological benefits. Early intervention improves ear appearance, boosts social integration, and enhances self-confidence. The procedure is safe and does not impact ear growth, making it a valuable early treatment option for children with prominent ears.