Hearing loss has a significant impact on quality of life, and may even compromise an individual’s ability to work and their safety – we use our hearing to constantly detect and react to environmental hazards around us. Hearing loss can have a profound impact on a person’s life. This is especially true for certain patient groups. For instance, the elderly, and those with co-existing problems that affect their ability to communicate (such as dementia, cerebrovascular disease or psychiatric disorders). Even those without co-morbidities suffer the burden of disease where communication is impaired: the young who are developing their speech and language skills and adults with language barriers or other impediments to their speech. The hearing apparatus is made up of conductive and sensorineural pathways, which may be affected by pathology, leading to deafness. This article describes the aetiology of conductive and sensorineural deafness, details the relevant clinical assessment and outlines management strategies in community practice.