The purposes of this study were to estimate the prevalence of impacted cerumen in a population of hospitalized elderly patients, and to evaluate the effect of cerumen removal in reversing hearing impairment The design was a pre-test/post-test static-group comparison Over a 1-year period, a random sample (n = 226) was drawn every third day from daily admission lists of English-speaking patients aged 65 or older, admitted to non-intensive care units of one hospital On either the second or third day of hospital stay, subjects were given a hearing test using an AudioScope and then their ear canals were examined for impacted cerumen Ear canal irrigations were performed on those subjects with impacted cerumen All subjects received a second hearing test Results indicate that impacted cerumen is a common condition in the hospitalized elderly Thirtyfive per cent of the sample had impacted cerumen, 19 9% bilaterally and 15 0% unilaterally Furthermore, removal of cerumen significantly improved hearing ability Improved hearing scores were obtained in 75.0% of the ears after the impacted cerumen was removed, with subjects hearing from one to three more tones per ear on the second hearing test An analysis of variance for repeated measures on hearing was computed to test for the effect of removing cerumen from individuals who had neither, one or both ears occluded A significant interaction (F = 146 83, d f = 2/223, P < 0.0001) between hearing tests and cerumen removal was found indicating that those with no occlusion had no change in hearing whereas both occluded groups increased with the greatest change for the bilateral group The findings of this study suggest that the hearing health of the elderly can be promoted if nurses working in the acute care setting routinely conduct otoscopic examinations as a part of their assessment and perform ear canal irrigations when impacted cerumen is found