Hearing loss is a widespread condition affecting over 1.5 billion people globally, with projections indicating it will rise to 2.5 billion by 2050. It significantly impacts quality of life, causing social isolation, depression, and cognitive decline. Oxidative stress is a key factor in the pathophysiology of hearing loss, contributing to damage in the cochlea and auditory system. The review explores the mechanisms linking oxidative stress to hearing loss, including the role of reactive oxygen species (ROS), antioxidant defenses, and pathways such as inflammation, ischemia-reperfusion injury, hair cell death, and mitochondrial dysfunction. Oxidative stress is implicated in various types of hearing loss, including age-related, noise-induced, and ototoxic hearing impairment. The cochlea's high metabolic activity and limited blood supply make it particularly vulnerable to oxidative damage. Antioxidant therapies, including pharmaceutical drugs, gene therapy, and dietary antioxidants, have shown promise in preventing and mitigating hearing loss. Emerging approaches like targeted drug delivery and gene therapy offer new possibilities for treating oxidative stress in the auditory system. The review emphasizes the importance of understanding these mechanisms to develop effective treatments and prevention strategies. It highlights the potential of antioxidant-based interventions and the need for further research into personalized treatment strategies. The review also discusses the challenges in translating research findings into clinical practice, including the need for better diagnostic tools and improved delivery methods. Future directions include regenerative therapies, personalized medicine, and the integration of machine learning and big data analytics to optimize treatment plans. The review concludes that a multidisciplinary approach is essential to address oxidative stress-related hearing loss, incorporating lifestyle changes, antioxidant therapies, and advanced medical interventions to improve the quality of life for those affected.Hearing loss is a widespread condition affecting over 1.5 billion people globally, with projections indicating it will rise to 2.5 billion by 2050. It significantly impacts quality of life, causing social isolation, depression, and cognitive decline. Oxidative stress is a key factor in the pathophysiology of hearing loss, contributing to damage in the cochlea and auditory system. The review explores the mechanisms linking oxidative stress to hearing loss, including the role of reactive oxygen species (ROS), antioxidant defenses, and pathways such as inflammation, ischemia-reperfusion injury, hair cell death, and mitochondrial dysfunction. Oxidative stress is implicated in various types of hearing loss, including age-related, noise-induced, and ototoxic hearing impairment. The cochlea's high metabolic activity and limited blood supply make it particularly vulnerable to oxidative damage. Antioxidant therapies, including pharmaceutical drugs, gene therapy, and dietary antioxidants, have shown promise in preventing and mitigating hearing loss. Emerging approaches like targeted drug delivery and gene therapy offer new possibilities for treating oxidative stress in the auditory system. The review emphasizes the importance of understanding these mechanisms to develop effective treatments and prevention strategies. It highlights the potential of antioxidant-based interventions and the need for further research into personalized treatment strategies. The review also discusses the challenges in translating research findings into clinical practice, including the need for better diagnostic tools and improved delivery methods. Future directions include regenerative therapies, personalized medicine, and the integration of machine learning and big data analytics to optimize treatment plans. The review concludes that a multidisciplinary approach is essential to address oxidative stress-related hearing loss, incorporating lifestyle changes, antioxidant therapies, and advanced medical interventions to improve the quality of life for those affected.