A healthy 47-year-old man presented to the dermatology office of the University of California San Diego, La Jolla, California, USA, in 2017 for a complete examination of his skin. On the posterior-superior helix of his left ear, an asymptomatic firm elastotic triangular prominence of skin-covered cartilage was observed, measuring 10 x 10 x 22 mm. In addition, there was a cutaneous pit in the left preauricular area. A similar yet less pronounced helical tubercle was also present on his right ear. The patient had no family history of auditory or renal impairment. Darwin's tubercles contribute to the individuality of human ears and may have applications in the fields of personal identification or forensic sciences. The presence of Darwin's tubercle has not been associated with any significant adverse clinical consequences or systemic anomalies, including chondrodermatitis or hearing and urinary anomalies. The concurrent pres-ence of Darwin's tubercle and a preauricular pit of the ipsilateral ear, such as that observed in the present case, may represent a coincidental occurrence rather than an association between the two conditions.