A questionnaire was sent to 100 consultant otolaryngologists from three selected health regions in the United Kingdom enquiring about their assessment and management of a patient presenting with sudden-onset sensorineural hearing loss. Seventy – six replied, of whom 42 stated a sub – specialist interest in otology. Seventy – eight percent of respondents would order routine blood tests including the erythrocyte sedimentation rate (ESR) and syphilis serology; in addition 38 per cent would order a magnetic resonance image (MRI) scan at the first presentation. The vast majority would treat such a patient (89 per cent), although the method and combination varied widely. A review of the literature confirmed that the level of evidence for treating this condition is limited and therefore the wide disparity in consultants’ practice is not surprising.