The purpose of the study was to evaluate the usefulness of hearing preservation in vestibular schwannoma (VS) surgery. Hearing preservation was attempted in 123 of 383 patients operated on during the years 1979 to 1993 at Helsinki University Hospital. Hearing was preserved in 47 cases. Pure-tone averages (PTA) better than 30 dB were found in 12 cases postoperatively. Seventy percent of the patients rated their hearing preservation as valuable or very valuable. Only 8% did not find hearing preservation useful. Postoperatively, tinnitus was present in 62% of the patients, and it was a moderate problem in only 23% of the patients. In only one subject was the tinnitus a handicap that reduced the quality of life. Based on these experiences, we encourage surgeons to continue efforts to preserve hearing in VS surgery.