Sudden sensorineural hearing loss (SNHL) has long been an enigma for otologists. The controversial definition, diagnosis and a limited understanding of the pathophysiology has resulted in lack of a standard treatment protocol. Systemic steroids are the most potent medication group currently in use for the treatment of sudden SNHL. However, a significant number of patients do not respond to steroid treatment or cannot receive steroids due to medical reasons. The higher concentration and longer duration of steroids in the inner ear after intratympanic administration make them effective in cases that are refractory to systemic steroids or in cases that present late . We conducted a study to evaluate the efficacy of intratympanic dexamethasone injection (ITDI) as a treatment modality for patients with idiopathic sudden sensorineural hearing loss (SSNHL), who were refractory to intravenous steroid therapy. Our encouraging results suggest that Intratympanic steroid therapy is a safe, inexpensive and effective treatment modality in refractory cases of sudden SNHL.