Introduction: This study aimed to describe the technique and assess the efficacy of the erector spinae plane (ESP) block in improving post-operative pain management for patients undergoing costochondral harvest for autologous ear reconstruction. Methods: A retrospective analysis was conducted on 5 patients who underwent autologous ear reconstruction at a single pediatric hospital between 2021 and 2022. All patients received an ESP block and outcomes including length of hospital stay and post-operative opioid and narcotic use were measured. Results: Post-operative pain control was achieved in all 5 patients as evidenced by an average hospital stay duration of 24 hours, an absence of morphine treatment and single-use oxycodone treatment. Conclusion: This study suggests that employing the ESP block technique could notably enhance post-operative pain management in patients undergoing autologous ear reconstruction with costochondral rib harvest. This approach, by reducing opioid consumption and shortening hospital stays, not only improves patient comfort and satisfaction but potentially mitigates the risk of opioid-related complications.