Previous literature shows that there are many cases where pilomatrixoma can be misdiagnosed. Despite this it was a diagnostic pitfall for us. More such cases of diagnostic errors if reported can improve the management of such patient in the clinical practice. Do not cut rationale: The point being harped upon is that in cases of a diagnostic dilemma think before your cut. Benign entities like pilomatrixoma if misdiagnosed can lead to mutilating procedures. This is especially true for cosmetically sensitive areas which might affect the psychosocial wellbeing. Have a life boat: When in doubt always plan ahead before cutting, infra-auricular flap is a robust option for ear lobule reconstruction as in this case. We recommend it to be considered in the armamentarium for pediatric cases. Having pilomatrixoma as a differential diagnosis for tumors for ear lobule which might mimic adenexal tumors/ round cell tumors. MDT approach: Managing pilomatrixoma effectively requires a multidisciplinary team, including otorhinolaryngologists, pathologists, and dermatologists. Such cases must be referred to the specialists(otolaryngologist) as in this case for management.