Background: hearing loss has serious consequences on language and communicative skills development. Identification of hearing loss at earlier ages will improve the success of rehabilitation programs. objectives: to identify the risk factors of hearing impairment to avoid or follow up these risk factors in preterm and full term infants that survive after neonatal intensive care unit (NICU) admission at Abu El Resh El Monira hospital and at Kasr El Aini hospital- Cairo University as; duration of admission, ototoxic drugs, indirect hyperbilirubinaemia, hypoxia, sepsis and mechanical ventilation. Subjects and methods: 150 preterm neonates and 110 full term neonates were screened at Audiology department at Kasr El Aini hospital- Cairo University Screening was done using two stages transient evoked otoacoustic emission (TEOAE) and auditory brain stem response (ABR). The preterm group, 78 (52%) males and 72 (48%) females with a mean gestational age of 32.7 weeks and a mean birth weight of 1750 grams whereas the full term group, 67 (60.9%) males and 43 (39.1%) females with a mean gestational age 38.5 weeks and a mean birth weight of 3100 grams. Results: 49 cases of preterm (32.6%) got pathological TEOAE whereas 36 cases of full term (32.7%) cases got and 48 of preterm (32%) cases got pathological ABR whereas 30 of full term cases (27.3%) got and the most important risk factors that lead to hearing impairment in the preterm group were the mechanical ventilation, use of vancomycin and use of combined vancomycin with amino glycosides (ototoxic drugs) (p=<0.001). Also the use of isolated amino glycosides (amikin) and loop diuretics were among the risk factors (p=0.044 and p=0.031 respectively), sepsis (p= 0.001) prolonged duration of admission (p=0.013) while in full term group were increase duration of oxygen support (p=0.001), mechanical ventilation (p=0.046), increase duration of amino glycosides (p=0.059). Conclusion: hearing impairment is a serious problem of newborn admitted to NICU as 32% of preterm and 27.3% of full term had hearing affection and the most frequent risk factors were mechanical ventilation, use of vancomycin and use of combined vancomycin with amino glycosides (ototoxic drugs) ,increase duration of admission in preterm group and mechanical ventilation in full term group.