Due to improved diagnostic techniques, acoustic neuromas more frequently are detected at an early stage. Subsequent treatment depends on such factors as expected tumor growth rate, tumor size, and patient age. The natural history of acoustic neuromas is still uncertain: This study was performed to examine possible correlations among tumor size, patient age, signs and symptoms, and duration of symptoms. The study included 164 patients with an acoustic neuroma who were treated at University Hospital Nijmegen, The Netherlands, over a period of 13 years. Comparisons were made between the findings of this study and the reports in the literature. No support was found for any of the correlations mentioned in other studies, and no relationships could be demonstrated between the parameters evaluated in this study. The authors therefore recommend that treatment policies be based only on well-established correlations.