Objective To analyze the audiological characteristics of acoustic neuroma (AN) patients, so as to provide reference for AN screening.Methods Clinical data of 397 patients with unilateral AN admitted to our department from August 2019 to April 2022 were retrospectively analyzed. All patients underwent pure tone audiometry (PTA), acoustic immittance, speech discrimination score (SDS), distortion product otoacoustic emission (DPOAE), auditory brainstem response (ABR) and cranial enhanced magnetic resonance imaging (MRI).Results There were 312 patients with typical symptoms and 85 with atypical presentations. Patients with sudden sensorineural hearing loss (n=25) accounted for 6.3%. Fifty-four cases with normal hearing had large or superlarge tumors, and 99 patients with total hearing loss had tumors of the internal auditory canal or medium size. The speech recognition ability of 5 cases with total hearing loss did not disappear completely. There were 245 cases of compatibal type of DPOAE, including cochlear type in 72 cases and retrocochlear type in 79. The sensitivity of ABR was 98.0%(389/397), and 3 of the 8 patients with normal ABR waveform had asymmetric hearing loss.Conclusions Patients with atypical presentations account for 21.4% of AN. AN can not be excluded in patients with sudden hearing loss, normal hearing, and normal ABR. DPOAE and ABR can be used as important methods for screening AN.