There are currently no standard guidelines for assessing hearing in pediatric patients who are evaluated for tympanostomy tubes. We describe the results of audiologic testing on 600 consecutive pediatric patients evaluated for tube placement. Six patients (1%) were found to have previously undiagnosed unilateral or bilateral moderate or severe neurosensory loss. Patients undergoing evaluation for tympanostomy tube placement have a low but significant likelihood of neurosensory hearing loss and should have age-appropriate hearing assessment as part of their overall evaluation.