Preauricular fistula is a common congenital malformation in which the patient usually feels only localized itching, and sometimes there is often a small amount of slightly smelly white discharge around the small eye when gently squeezed. The opening of the fistula is mostly located in front of the foot of the ear wheel, but a few can be in the triangular fossa of the auricle or in the cavity of the earnail. Congenital preauricular fistulas are classified as simple, infected, or secretory. They are usually asymptomatic. When pressed, a little thin mucus or milky sebum-like material may spill out of the fistula, causing local itching and discomfort. Asymptomatic or non-infected cases can be left untreated. In cases of localized itching and discharge, surgical excision is recommended.