The present chapter explores the growing potential of nanoparticles as carriers for drug delivery aimed at treating hearing loss and other inner ear disorders. The anatomical structure of the ear, including the outer, middle, and inner regions, poses several challenges, such as the selective permeability of the round window membrane (RWM) and the possibility of drug loss through Eustachian tube clearance. Additionally, barriers like the blood–cochlear barrier and the limited vascularization of the inner ear make drug delivery particularly difficult. Nanoparticle-based systems offer a promising solution by enabling targeted, minimally invasive delivery while improving therapeutic outcomes and minimizing systemic side effects. Ongoing research emphasizes enhancing the permeability of the RWM and improving drug uptake and retention using various nanocarriers. Tailored systems such as liposomes, polymer-based nanoparticles, and amorphous silica particles allow for site-specific and controlled release, helping to reduce ototoxicity and improve treatment precision. Innovative strategies, including functionalized nanocarriers designed for intracochlear delivery, are showing potential in targeting specific cell types within the cochlea. This manuscript highlights the critical role of nanotechnology in overcoming the complex structural and physiological barriers of the ear and advancing treatment options for auditory disorders.