Hearing loss is a significant global issue, affecting communication and social life, and is associated with an increased risk of dementia. Sensorineural hearing loss, the most common type, results from damage to the inner ear due to various factors such as ischemia, noise, trauma, aging, and ototoxic drugs. Oxidative stress, particularly in mitochondria, is a common mechanism underlying several cochlear pathologies. The cochlea, with its high-energy metabolism, is highly susceptible to oxidative stress. Animal studies have demonstrated the potential of antioxidants in treating hearing loss, but human studies are limited. This review discusses the relationship between sensorineural hearing loss and reactive oxygen species (ROS), focusing on age-related hearing loss, noise-induced hearing loss, and ischemia-reperfusion injury. It highlights the current status and future perspectives of ROS-targeted therapies for sensorineural hearing loss.Hearing loss is a significant global issue, affecting communication and social life, and is associated with an increased risk of dementia. Sensorineural hearing loss, the most common type, results from damage to the inner ear due to various factors such as ischemia, noise, trauma, aging, and ototoxic drugs. Oxidative stress, particularly in mitochondria, is a common mechanism underlying several cochlear pathologies. The cochlea, with its high-energy metabolism, is highly susceptible to oxidative stress. Animal studies have demonstrated the potential of antioxidants in treating hearing loss, but human studies are limited. This review discusses the relationship between sensorineural hearing loss and reactive oxygen species (ROS), focusing on age-related hearing loss, noise-induced hearing loss, and ischemia-reperfusion injury. It highlights the current status and future perspectives of ROS-targeted therapies for sensorineural hearing loss.