Introduction <p>Hearing loss is a disabling element in Menière’s disease. Being able to identify at the onset which patients are going to suffer greater hearing impairment is critical. Sometimes, Menière’s disease can present as an episode of sudden hearing loss (SSNHL) without knowing its prognostic implications.</p> Objectives <p>To identify whether patients with greater hearing impairment after 10 years of evolution (stage IV of Menière’s disease) present a higher rate of sudden hearing loss at the onset of the disease compared to those with lower hearing loss (stages I-III).</p> Methods <p>Two retrospective cohorts of patients with Menière’s disease with 10 years of follow-up: patients with a PTA (pure tone average) at 10 years greater than 70 dB and with a PTA lower than 70 dB (STROBE guidelines). The PTAs at onset, with progression and the profile of hearing loss at onset (sudden/progressive) were compared. We also compared the profile of patients with SSNHL against those with gradual loss.</p> Results <p>71 patients were analyzed. 22.4% of patients presented sudden hearing loss. We have not found a greater incidence of SSNHL in the cohort of poor hearing prognosis. But patients with sudden hearing loss at onset had a higher risk of worse hearing loss after 10 years (46.67%) with a significative worse PTA after 10 years of progression, we did not find differences on PTAs at the onset.</p> Conclusions <p>The onset of Menière’s disease as sudden hearing loss could be associated with a greater probability of presenting a worse PTA after progression.</p>