[Abstract] Objective: To investigate the relationship between diffusion tensor imaging (DTI) parameters of magnetic resonance of conduction pathway and prognosis in children with congenital sensorineural hearing-loss. Methods: 136 children with congenital sensorineural hearing-loss treated in our hospital from January 2017 to March 2020 were selected as observation group, and 118 children with normal hearing at the same period were selected as control group, and all of them were examined by DTI, including apparent dispersion coefficient (ADC) value and fractional anisotropy (FA) value of bilateral trapezoid body, transverse temporal gyrus, superior temporal gyrus, medial geniculate body, auditory radiation, superior olivary nucleus, dorsal fossa nucleus, inferior colliculus, ventral fossa nucleus and auditory nerve area. The ADC and FA values of the above parts of the observation group and control group were compared. In addition, followed up for 1 year after treatment, and the observation group was divided into good prognosis group and poor prognosis group according to the categories of auditory performance (CAP), and the ADC value and FA value of each part between the good prognosis group and the poor prognosis group were compared, and the correlation between ADC value, FA value and CAP score were analyzed. Results: There was no significant difference in the ADC values of trapezoid, medial geniculate body, fossa dorsal nucleus, inferior colliculus, fossa ventral nucleus and auditory nerve between the observation group and the control group (P > 0.05), and there was no significant difference in the FA values of dorsal fossa nucleus, ventral fossa nucleus and auditory nerve between the two groups (P > 0.05). The ADC values of transverse temporal gyrus, superior temporal gyrus, auditory radiation and superior olivary nucleus in the observation group were higher than those in the control group (P < 0.05), and the FA values of trapezoid body, transverse temporal gyrus, superior temporal gyrus, medial geniculate body, auditory radiation, superior olivary nucleus and inferior colliculus were lower than those in the control group (P < 0.05). One year after operation, the good prognosis rate and poor prognosis rate of the observation group were 65.44% (89/136) and 34.56% (47/136) respectively, and there was no significant difference in ADC values of trapezium, medial geniculate body, dorsal fossa nucleus, inferior colliculus, ventral fossa nucleus and auditory nerve area and FA values of dorsal fossa nucleus, ventral fossa nucleus and auditory nerve area between the two groups (P > 0.05), but the ADC values of transverse temporal gyrus, superior temporal gyrus, auditory radiation and superior olivary nucleus in poor prognosis group were higher than those in good prognosis group (P < 0.05), while the FA values of trapezoid body, transverse temporal gyrus, superior temporal gyrus, medial geniculate body, auditory radiation, superior olivary nucleus and inferior colliculus were lower than those in good prognosis group (P < 0.05). Pearson correlation analysis showed that there was no correlation between the ADC values of the trapezoid body, medial geniculate body, dorsal fossa nucleus, inferior colliculus, ventral fossa nucleus and auditory nerve area and CAP score (P > 0.05), and there was no correlation between FA of the dorsal fossa nucleus, ventral fossa nucleus and auditory nerve area and CAP score (P > 0.05), but the ADC values of transverse temporal gyrus, superior temporal gyrus, auditory radiation and superior olivary nucleus were negatively correlated with CAP score (P < 0.05), while FA values of trapezoid body, transverse temporal gyrus, superior temporal gyrus, medial geniculate body, auditory radiation, superior olivary nucleus and inferior colliculus were positively correlated with CAP score (P < 0.05). Conclusion: There are abnormal DTI parameters at some specific positions in the auditory conduction pathway in children with congenital sensorineural hearing-loss, and the changes of DTI parameters are closely related to prognosis, and the ADC values of transverse temporal gyrus, superior temporal gyrus, auditory radiation and superior olivary nucleus are negatively correlated with postoperative hearing recovery effect, but the FA values of trapezoid body, transverse temporal gyrus, superior temporal gyrus, medial geniculate body, auditory radiation, superior olivary nucleus and inferior colliculus are positively correlated with the postoperative hearing recovery effect, which have an important guiding role in clinical diagnosis and treatment.