The aim of this study was to estimate the prevalence of self-reported hearing loss among elderly people in São Paulo, Brazil, according to socio-demographic characteristics and to identify associated factors. Data were from the São Paulo Health Survey (ISA-Capital 2003), and the subgroup of elderly (n = 872) was analyzed. The χ(2) test was used to verify the association between self-reported hearing loss and socio-demographic characteristics. The statistical analyses used Poisson regression. Prevalence of self-reported hearing loss in the elderly was 11.2%, and was higher in men (PR = 1.86; 95%CI: 1.19-2.92). There was an important lack of knowledge among the elderly regarding the causes of their hearing loss (42.5%). Among the sample, 25.5% reported difficulties in leisure-time activities and 11.4% needed help in routine activities, while 63.3% required no assistance due to their impairment. The high prevalence of self-reported hearing loss in the elderly, especially in men, highlights the importance of this public health problem. Population aging is a new reality, placing increasing demands on healthcare professionals and government.