Viruses are a common cause of hearing loss both in children and adults. This article provides a good review of the viral causes of hearing loss and can be regarded as an essential read. The authors divide the viruses into three categories: those causing congenital hearing loss (cytomegalovirus, rubella and lymphocytic choriomeningitis virus); those causing both acquired and congenital hearing loss (human immunodeficiency virus and herpes simplex virus types 1 and 2); and lastly those causing acquired hearing loss (measles, varicella zoster virus, mumps and West Nile virus). Prevention and management are discussed for each of these. Sensorineural hearing loss is the commonest outcome and treatments discussed range from primary prevention by vaccination, antiviral therapy to treat the acute phase and reduce associated complications, and hearing aids or cochlear implants to treat the subsequent hearing loss. They highlight conductive hearing loss secondary to recurrent bacterial infections of the middle and outer ear in immuno-compromised individuals as a virus related hearing loss. Furthermore they advocate recommending vaccination against common viruses to patients and parents to protect against the risk of these devastating complications.