Primary cutaneous acral CD8+ T-cell lymphomas (PCACTL) is a rare lymphoproliferative disorder consisting of atypical CD8+ cells localised to any acral sites. Since its first description in 2007, less than 50 cases have been described globally and it has been recently recognised in the revised WHO 2016 classification and updated WHO-EORTC 2018 classification for primary cutaneous lymphomas as a provisional entity. Classically, these tumours clinically present as a slow growing non-ulcerated nodule or papule. It is essential to distinguish PCACTL from other more aggressive cutaneous lymphomas, especially primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma. This can be achieved histologically by the presence of the Grenz zone and the lack of epidermal infiltration by lymphoid cells. We herein report an unusual case of bilateral ear PCACTL presentation highlighting the need for greater awareness of this condition to prevent unnecessarily aggressive intervention.