Oxidative stress plays a critical role in sensorineural hearing loss (SNHL), which is the most common type of hearing loss. SNHL results from damage to the inner ear, including hair cells in the cochlea, and is associated with aging, noise exposure, ototoxic drugs, and ischemia-reperfusion injury. Reactive oxygen species (ROS) contribute to cochlear damage by inducing apoptosis, inflammation, and oxidative stress, which disrupts the function of hair cells and the auditory system. The cochlea, with its high metabolic demands, is particularly vulnerable to oxidative stress, especially in mitochondria. Antioxidants have shown promise in animal studies for protecting against hearing loss by reducing ROS levels and mitigating mitochondrial damage. However, clinical evidence remains limited, and further research is needed to validate the efficacy of antioxidants in humans. The review highlights the mechanisms linking oxidative stress to various types of SNHL, including age-related, noise-induced, and drug-induced hearing loss, and discusses the potential of ROS-targeted therapies. While antioxidants may offer therapeutic benefits, their role in human treatment requires more clinical trials. Understanding the relationship between oxidative stress and hearing loss is essential for developing effective interventions to prevent and treat SNHL.Oxidative stress plays a critical role in sensorineural hearing loss (SNHL), which is the most common type of hearing loss. SNHL results from damage to the inner ear, including hair cells in the cochlea, and is associated with aging, noise exposure, ototoxic drugs, and ischemia-reperfusion injury. Reactive oxygen species (ROS) contribute to cochlear damage by inducing apoptosis, inflammation, and oxidative stress, which disrupts the function of hair cells and the auditory system. The cochlea, with its high metabolic demands, is particularly vulnerable to oxidative stress, especially in mitochondria. Antioxidants have shown promise in animal studies for protecting against hearing loss by reducing ROS levels and mitigating mitochondrial damage. However, clinical evidence remains limited, and further research is needed to validate the efficacy of antioxidants in humans. The review highlights the mechanisms linking oxidative stress to various types of SNHL, including age-related, noise-induced, and drug-induced hearing loss, and discusses the potential of ROS-targeted therapies. While antioxidants may offer therapeutic benefits, their role in human treatment requires more clinical trials. Understanding the relationship between oxidative stress and hearing loss is essential for developing effective interventions to prevent and treat SNHL.