Objectives: To evaluate the risk of sensorineural hearing loss (SNHL) after mastoidectomy in patients with acute mastoiditis (AM) and compare patients who received surgical versus conservative treatment. Methods: A retrospective cohort study of medical records of all patients who were diagnosed with AM at Soroka medical center between the years 2005-2020 and had an available hearing test. Data included demographics, clinical characteristic, comorbidities, and a pure tune audiometry conducted in our institution after recovery. Hearing loss (HL) was defined as a decrease of 15 dB or more in a given frequency. HL was categorized as mild (25-40 dB decrease), moderate (41-70) or severe (71db<). Frequencies range was categorized as Low (<500 Hz), middle (501-2000 HZ) or high (>2001) pitch. We divided the patients to two groups; patients who received conservative treatment and patients who underwent surgery. Results: A total of 24 patients met the inclusion/exclusion criteria, 12 underwent surgery (mean age 20.2 m) and 12 received conservative treatment (mean age 20.1 m). A definite CHL of 10 to 20 dB could be diagnosed in 3 of the 5 patients in each group, who had bone conduction thresholds measured. SNHL was not observed in any of the patients old enough to have bone conduction tested Conclusions: This is the first study to examine HL of children following AM. From our limited study it seems that the disease itself as well as mastoidectomy is not a risk factor for developing SNHL later in life.