The information concerning general pathological changes in hair cells of the spiral organ is reviewed. The conditions for the onset, morphological picture of dystrophy, necrosis, apoptosis typical for hair cells in respect to structural and functional features of the sensory epithelium of the spiral organ are outlined. Nonspecific morphological changes of the spiral organ neuroepithelium after the action of damaging agents of different origin (such ototoxic drugs as aminoglycoside antibiotics and others, intensive acoustic impacts, ageing of the acoustic analyzer) are emphasized.