Cauliflower ear is a condition that results from a direct blow to the outer ear. The skin on the surface of the ear is the only blood supply for the cartilage, and when blood or other fluids fill the space in between, it disrupts normal blood flow. Without adequate blood flow, the cartilage is starved of vital nutrients, causing the tissue to become hard and fibrous, resulting in disfigurement. The main cause of cauliflower ear is blunt force trauma, which can occur in any activity where significant shearing or impact forces are experienced by the pinna, leading to an auricular hematoma. The most common cause of cauliflower ear is a hit to the ear or repeated hits to the ear that lead to hematomas, or small collections of blood that clot and block the flow of blood and nutrients. These can also occur when skin is pulled away from cartilage, the semi-rigid tissue that gives the ear its shape. Usually, cauliflower ear is related to sports injuries, but not always. Any trauma to the ear can cause it. The initial symptoms of the types of injuries that lead to cauliflower ear are similar to the symptoms one might experience from blunt trauma elsewhere in the body. You may have swelling, and the area may be red or bruised. Its important not to shrug off such symptoms if you have received a blow, or multiple blows, to the ear. Prompt treatment can prevent the development of cauliflower ear.