A significant proportion of school children are hearing impaired and they suffer from various academic and adjustment problems. Identification of risk factors will help in containing the problems. In this context this study aims to find the causative factors of hearing impairment. Data obtained from 1000 case files indicated that mean age of detection by parents was 3.03 years. A considerable gap between the mean age of detection and availing audiological rehabilitation was observed. Prenatal diseases, exposure to X-rays during gestation, premature delivery, low birth weight, postnatal jaundice, neonatal seizures and rubella were the significant predictors of hearing impairment. Therefore, children with a history of these predictive factors should be periodically screened for hearing impairment. At a higher level, mass education programmes may include imparting information on preventive measures and early identification of these risk factors.