This chapter describes the management of a patient presenting with a primary complaint of hearing loss. The type of hearing loss can be characterized audiologically into conductive, sensorineural, mixed, auditory processing disorder and nonorganic. Patients with hearing loss that changes over days/weeks/months form an important clinical subset, as it implies the underlying pathology is active and the patient at risk of progression. If the patient has chronic otitis media (COM), the activity will usually but not always declare itself with other symptoms such as otorrhea. An asymmetrical hearing loss is defined for the purposes of this chapter as a difference in pure-tone thresholds of ≥20 dB at two adjacent frequencies as recommended by Gimsing (2010). A detailed description on the epidemiology of adult onset hearing loss has been presented in this chapter.