Ticks were extracted from ear canal of 318 cases in Hospital Tengku Ampuan Afzan,Kuantan,Pahang over a 5-year period(January 2002 to December 2006).A total of 329 ticks were recorded and a majority belonged to the genus Dermacentor(99.7%).The genus was represented by Dermacentor atrosignatus,Dermacentor compactus and Dermacentor steini.A single tick of the genus Haemaphysalis was found.All active stages(larvae, nymphs and adults) were present.The nymphal stages were most frequently encountered(82.4%).Usually, there was only one tick per case.However,there were 7 cases where 2 or 3 ticks were extracted from a single ear canal.Throughout the study,there were 6 repeat cases.Average body engorgement indices for detached larvae,nymph,male and female ticks were 1.04,1.24,1.32 and 1.31,respectively.Based on these indices,duration of attachment was then predicted.Attachment for most nymphal(99.6%) and all adult ticks were less than 24 hours.Only 1 nymphal tick attached for a 60 hours’duration.Ticks were commonly found in the bony part of ear auditory canal(47.3%),followed by tympanic membrane(29.1%) and cartilage part of ear auditory canal(22.0%);a small percent was attached to the pinna(1.6%).All ticks were alive before extraction.However,most attached ticks were found dead(71.7%) after extraction.Majority of the ticks were intact(90.3%) while others were either in a bad condition(3.6%) or broken(6.1%).Those alive were either unfed or at early stage of feeding.Generally,removal of ticks did not result in any complication (61.4%) to the cases.The most common complication was bleeding(27.6%),followed by haematoma of external auditory canal(5.5%),haematoma of tympanic membrane(3.1%) and perforated tympanic membrane (1.6%).Bleeding was a common complication at the site of skin abrasion due to the strong grip of ticks ’mouthparts that were deeply embedded into the skin of cases.In this study,32.5%of removal ticks had remnants of case tissues attached to the ticks’mouthparts. Ticks were extracted from ear canal of 318 cases in Hospital Tengku Ampuan Afzan, Kuantan, Pahang over a 5-year period (January 2002 to December 2006). A total of 329 ticks were recorded and a majority belonged to the genus Dermacentor (99.7% ). The genus was represented by Dermacentor atrosignatus, Dermacentor compactus and Dermacentor steini. A single tick of the genus Haemaphysalis was found. All active stages (larvae, nymphs and adults) were present. The nymphal stages were most frequently encountered (82.4%) .Usually, there was only one tick per case. There, there were 7 cases where 2 or 3 ticks were extracted from a single ear canal. Throughout the study, there were 6 repeat cases. Average body engorgement indices for detached larvae, nymph, male and female ticks were 1.04, 1.24, 1.32 and 1.31, respectively. Based on these indices, duration of attachment was then predicted. Attention for most nymphal (99.6%) and all adult ticks were less than 24 hours. Only 1 nymphal tick attached for a 60 hours’duration. Ticks were commonly found in the bony part of ear auditory canal (47.3%), followed by tympanic membrane (29.1%) and cartilage part of ear auditory canal (22.0%); a small percent was attached to the pinna (1.6%). All ticks were alive before extraction. Host, most attached ticks were found dead (71.7%) after extraction. Major of the ticks were intact (90.3%) while others were either in a bad condition (3.6%) or broken (6.1%) .Those alive either either unfed or at early stage of feeding. Generalized, removal of ticks did not result in any complication (61.4%) to the cases. Most common complication was bleeding (27.6%), followed by haematoma of external auditory canal (5.5%), haematoma of tympanic membrane (3.1%) and perforated tympanic membrane (1.6%). Bleeding was a common complication at the site of skin abrasion due to the strong grip of ticks’ mouthparts that were deeply embedded into the skin of cases. this study, 32.5% of removal ticks had remnants of caseaves attached to the ticks’mouthparts.