The purpose of this study was to determine the incidence, degree and reversibility of hearing loss following spinal anaesthesia with bupivacaine and secondarily to see if there is a relationship between post-spinal headache and hearing loss. A prospective series of 35 patients admitted for elective Caesarean section under a standardized spinal anaesthetic was investigated. Otolaryngological examination and pure tone audiometry in the frequency range 250 Hz to 8 KHz were done on the day before surgery and on post-operative days 1 and 5. Five patients developed a reversible sensorineural hearing loss (mean loss 14.6 dB). This loss was either unilateral (3) or bilateral (2) and affected the low frequencies in all five patients. The demographic data for both groups (i.e. no change in hearing/sensorineural loss) was similar for age, weight, height, blood pressure change and level of sensory block. There was no association found with post-spinal headache.