Reconstruction of the auricle can pose unique challenges to the clinician given the complex surface anatomy. The Antia-Buch flap was introduced by Antia and Buch in 1967, revolutionised the approach to auricular defects. Initially conceptualized to address small to medium-sized helical rim defects, this local transposition flap has undergone various modifications to enhance its versatility and effectiveness. The principle of the procedure is using the skin and cartilage adjacent to the defect to advance based on a wide retroauricular pedicle. This particular reconstruction is a reliable technique to preserving the ears contour. Later developments have refined on the classic technique, including an incision of the transition line from helix to dorsal ear, and incorporating a posterior auricular artery based pedicle to improve vascularity. This flap has demonstrated its adaptability and versatility with modern techniques improving the endurance of the flap.