The aim of this work was to determine the prevalence of hearing loss (HL) and its association with different ear problems among schoolboys in Abha City, Asir Region, Saudi Arabia. A representative sample of 974 schoolboys ages six to 12 years were subjected to both audiometric and otoscopic examinations. Audiometric examination identified 43 children with HL (40 conductive and three sensorineural), making a prevalence of 4.4% (1.7% mild, 2% moderate and 0.7% severe HL). Otoscopic examination revealed ear problems among 26.9% of schoolboys with the following prevalences: wax (21.3%), acute otitis media (1.9%), chronic otitis media (1.0%), foreign body (0.7%), otitis externa (0.7%), and congenital anomaly of the auricle (0.4%). Impacted wax accounted for reversible HL among a quarter (25.6%) of the hearing impaired children, whereas chronic otitis media accounted for 11.6%; acute otitis media 9.3%; otitis media with effusion, foreign body and congenital anomaly of the auricle each accounted for 2.3%. A significantly higher frequency of HL was detected among children with otitis media than among children without ear conditions (29.4% vs. 2.8%, P<0.01). The prevalence of HL among Abha schoolboys was comparable to that in developed countries, but was lower than that in developing countries. Such prevalence was mostly caused by impacted wax and otitis media. Thus, attention should be given to regular screening for early detection and removal of the impacted wax for correcting the high prevalence of reversible HL due to such conditions. Children of low social class should be regarded as a high risk group for whom regular hearing screening is recommended.