Sudden sensorineural hearing loss (SSNHL) is a rare but emergent condition that afflicts approximately 4,000 Americans annually (Ciorba, Faita, Bianchini, Aimoni, & Scanelli, 2013; Scapa & Friedland, 2009; Stachler et al., 2012). It causes unilateral nerve loss of hearing that may not recover left untreated. Because SSNHL is uncommon, practitioners may be unaware of the urgency or the protocol for immediate testing and treatment. Aural fullness, a common presenting symptom of SSNHL, overlaps with more common outer and middle ear problems resulting in misdiagnosis and/or delayed diagnosis and treatment. This case study will lead practitioners through the necessary diagnostic reasoning process to identify, diagnose, treat, and refer SSNHL patients effectively.