An 9 year old intact open female huacaya alpaca presented to Cornell University Hospital for Animals Large Animal Surgery service for a two-year history of chronic bilateral otitis externa and media. On several occasions the ears were cultured and appropriate antibiotics were prescribed. A skull computed tomography (CT) and bilateral total ear canal ablation and lateral bulla osteotomy were performed. The procedures for each ear canal were staged eight weeks apart. After successful procedures, cytology, and a culture and sensitivity were performed, guiding appropriate post-operative antibiotic administration.