Hidden hearing loss (HHL) is a type of hearing impairment characterized by normal pure tone threshold audiometry (PTA) but impaired speech recognition and coding ability in noisy environments. At present, synaptic and nerve damage is the most likely pathological mechanism of HHL. Noise exposure, aging and ototoxic drugs may affect the occurrence of HHL, but its clinical manifestations and routine examinations have no obvious abnormalities, which may easily lead to missed diagnosis of HHL. This article reviews the current research status of HHL, including its possible pathogenesis, influencing factors, clinical diagnosis and treatment methods, and puts forward its future research direction, in order to provide basis for the early prevention, diagnosis and treatment of HHL.