INTRODUCTION Neonatal deafness is diagnosed late, approximately at 24 to 36 months of age. At this age rehabilitation procedures are unable to ensure complete development of speech and thus prevent the full participation of the deaf child in social living.2 OBJECTIVES Our aim of study is to identify various risk factors adversely affecting hearing and to identify hearing impairment in high-risk new-born. MATERIALS AND METHODS 300 new-borns, born out of high risk pregnancy or intranatal or neonatal complications, requiring NICU admission, were screened for hearing loss with transient evoked otoacoustic emission .Results mentioned in terms of ‘pass’ (normal hearing) or ‘refer’ (who needs further evaluation). Follow up OAE examination was done in refer cases after 7 to 10 days. Brainstem evoked response audiometry (BERA) done in those cases, those ‘failing’ on second examination. Tympanometry done in those cases who shows normal BERA examination to rule out middle ear pathology2, 5, 9, 10. RESULTS Out of 300 new-borns 24 showed OAE‘refer’ at first examination and out of these 24 ‘refer’, 18 were ‘fail’ on second OAE examination. Out of these 18 who underwent BERA examination, 12 showed pathological deafness and 6 showed normal BERA examination .These 6 new-borns underwenttympanometry study and showed normal results. CONCLUSION Incidence of hearing loss in high risk new-borns in this study was 8 % .Thus hearing screening should be implemented at all levels of health care facilities .If all new-borns could not be screened due to infrastructural problem then at least the high risk new-borns must be screened.