Sudden sensorineural hearing loss is a medical emergency in search of an appropriate treatment. Almost all aspects of this disease process are disputed in the literature. The natural course of the disease process has not been well defined, although spontaneous recovery in a percentage of patients appears well accepted. Little scientific data exist to develop an evidence-based treatment protocol. The more common elements of treatment in the United States include oral steroid therapy, transtympanic steroid therapy, and potentially oral antiviral therapy. Other therapies are used with great frequency, and their potential should not be discounted.