Aims: This presentation explores the evolution of ear piercing in Australia, tracing its journey from Indigenous cultural practice and European superstition to contemporary fashion and medical management. The study aims to highlight how this seemingly simple act reflects broader changes in Australian identity, social norms, and the intersection between body art and otolaryngology. Methodology: A historical review of anthropological records, colonial journals, public health archives, and popular media was conducted to chart changing attitudes toward ear piercing. Key periods examined include Indigenous ceremonial practices, colonial maritime traditions, medicalisation in the early 20th century, and the commercial and countercultural trends of the post-war decades. Results: Among Aboriginal communities, ear modification carried ceremonial and spiritual meaning, embedding sound and identity within Country. Early European settlers viewed piercings with suspicion, yet sailors embraced gold hoops as talismans. By the early 1900s, piercing entered the medical realm-performed by doctors and pharmacists under antiseptic techniques. The mid-century suburban jeweller redefined the act as a rite of passage, while the punk movement of the 1970s transformed it into an expression of rebellion. Today, piercing spans art, identity, and medicine, with ENT specialists often managing complications of infection, trauma, or misplaced enthusiasm. Conclusion: The history of ear piercing in Australia mirrors the nation’s cultural evolution—bold, adaptive, and occasionally defiant. From ancient ceremony to high-street fashion, piercing has transitioned from ritual to rebellion to routine care. Its story bridges anthropology and otolaryngology, reminding us that even the smallest hole in the ear can reveal a great deal about who we are, where we’ve come from, and how culture and medicine continue to intertwine.