Objective Hidden hearing loss(HHL)is characterized by normal pure tone audiometry but severe speech recognition impairment in noisy environments.Currently,approximately 1%-10%of people with normal hearing thresholds have symptoms of HHL.Unlike other types of sensorineural hearing loss,the pathological damage of HHL doesn't involve the death or loss of hair cells,but is mainly manifested by the reduction of the ribbon synapses between hair cells and spiral ganglion neuron cells.Patients with early HHL are more likely to develop age-related hearing loss in the future,and their tolerance to ototoxic drugs and noise will decrease significantly.Therefore,this review summarizes the research progress on the pathogenesis and diagnosis of HHL to better cope with its impact on the population.