Discovered in the 1940s, the aminoglycoside antibiotics were the long-sought remedy for tuberculosis and other serious bacterial infections. They are still one of the most commonly used antibiotics today, thanks to the combination of their high efficacy with low cost. This review begins by addressing some of the history and the acute side effects of aminoglycosides. It then details their chronic toxicity to the inner ear (ototoxicity). The review concludes with recent advances that have demonstrated free-radical reactions as the underlying mechanism and intervention with antioxidant/chelation therapy to prevent aminoglycoside ototoxicity.