Objective: To present a different location, lateral to the middle fossa, as a new surgical alternative for an active transcutaneous bone conduction implant (ATBCI) in children with microtia and external auditory canal atresia (EACA) who cannot undergo traditional surgery due to altered anatomy or desire for future aesthetic reconstruction. Study Design: Prospective, longitudinal, descriptive study. The surgical technique was developed. Preoperative and postoperative information was analyzed. Setting: Tertiary pediatric hospital in Santiago, Chile. Patients: Eight children with unilateral EACA and microtia InterventionATBCI lateral to the middle fossa. Main Outcome MeasureSurgical, audiological, and quality-of-life outcomes. ResultEight children with EACA were implanted. Surgery was uneventful except for one seroma. This placement is lateral to the middle fossa, serving as a location marker. Their average age was 13 years old. The average follow-up was 21 months. All patients had conductive hearing loss. The audiological and quality-of-life results were as expected for this device. Conclusions: This location for the ATBCI was proven to be safe and effective for treating pediatric patients with EACA who desire future aesthetic reconstruction. This new surgical technique is safe and faster than the one suggested by the manufacturer due to the flat bone in this region of the skull. The outcomes are comparable to those obtained with the traditional location described for this device.