Intraoperative neurophysiologic monitoring of auditory function improves surgical outcomes and reduces postoperative hearing loss following procedures that place the eighth cranial nerve or the brainstem at risk of ischemic, thermal, or mechanical injury. However, the operative setting poses unique obstacles in neurophysiology. Providing the surgeon with the specific information requested and achieving the desired patient impact depends first on the selection of the appropriate stimulation and recording techniques. Additionally, the patient’s position, time constraints, and the volatile electrical environment of the operating room all introduce challenges in the successful recording of neuromonitoring data. This chapter reviews the physiology of hearing function and summarizes the neurophysiologic parameters and practical techniques used for recording auditory responses, as well as the utility of these modalities in various surgical procedures.