The aim of this study was to detect the incidence of sensorineural hearing loss in (RA) patients and to correlate incidence of sensorineural hearing loss with disease manifestations and activity. This study included 35 patients with RA and 20 age and sex matched healthy persons as controls. Patients underwent clinical examination, and laboratory investigations. Hand radiographs of RA patients were evaluated according to Steinbrocker Method. Both patients and control groups underwent complete audiological evaluation using otoscopic examination, pure tone audiometry immittance metry (Tympanogram and acoustic reflex thresholds) and evaluation of auditory brain-stem response. Sensorineural hearing loss was detected in 13 (37.14%) out of 35 RA patients as detected by pure tone audiometry. Ten (76.9%) out of thirteen RA patients with sensorineural hearing loss had abnormal ABR values which is suggestive of retrocochlear lesion. The other three patients (23.1%) had normal ABR values which are suggestive of cochlear lesion. No statistically significant correlation was found between results of pure tone audiometry at all frequencies and parameters of disease activity, age of patient, age at disease onset and disease duration. Treatment with hydroxychloroquine is associated with increased incidence of sensorineural hearing loss as we found 8 (38%) RA patients, out of 21 RA patients treating with hydroxychloroquine had mild sensorineural hearing loss. The study concluded that the incidence of sensorineural hearing loss is elevated in patients with rheumatoid arthritis. Incidence of sensorineural hearing loss increased with hydroxychloroquine administration but not correlated with presence of SC nodules, secondary Sjogren's syndrome or with disease activity.