목적: ABRL(auditory brainstem response latency) is still used for screening acoustic neuroma in patients with asymmetrical SNHL(sensorineural hearing loss). Many studies researched the false negative rate of ABRL within patients having acoustic neuromas. But, studies on positive predictive value of ABRL are rare recently. We studied false negative and positive predictive value of ABRL in screening acoustic neuroma. 방법:We retrospectively review medical records of patients with asymmetrical SNHL who had both ABR tracings and MRI from January 2010 to December 2014. ABRL was considered abnormal when the interaural wave I-V latency difference or the interaural wave V latency difference was greater than 0.2ms. And absent waveform was considered abnormal. 결과:There were 410 patients who had both ABRL and MRI. Among 410 patients, 40 patients were excluded for their hearing threshold over 90dB. This study involved 370 patients. Normal ABRL patients were 118. Among normal ABRL patients, three patients had the acoustic neuromas (intracanaliculi N=2, diameter<1cm N=1). False negative rate of ABRL was 2.5%. Abnormal ABRL patients were 252. Among abnormal ABRL patients, twenty seven patients had acoustic neuromas (intracanaliculi N=10, diameter<1cm N=4, 1-2cm N=5, 2-3cm N=4, 3-4cm N=4) and one patient had epidermoid in CP angle and one had jugular foramen tumor. Positive predictive value of ABRL was 11.5%. 결론:In patients with asymmetric SNHL, it is believed that only about 1 in 1000 has acoustic neuroma. It is hard to study MRI in all of asymmetric SNHL. In this study, ABRL had a low rate of false negatives and high rate of positive predictive values. ABRL is still meaningful to screen the acoustic neuroma.