• This is a retrospective case series study examining the role of salvage intratympanic steroid injections (ITS) in patients presenting with idiopathic sudden sensorineural hearing loss (SSNHL) following poor response to initial oral steroid treatment. • Pure tone thresholds were reviewed pre-treatment, post oral steroid therapy and 6 weeks post ITS. • After oral steroid therapy alone, there was a mean average threshold change of 6.2dBHL (range of -13.8dB to 33.8dB). This was found to be statistically significant with severely affected patients (defined as average presenting threshold >71dB). • The mean average threshold improvement post-ITS therapy was 2.9dB (range of -22.5dB to 61.3dB), this was not found to be statistically significant. • Some patients experienced moderate improvement following ITS therapy, however no specific subgroup was identified to benefit more from ITS therapy.