Auditory deprivation in early life significantly effects speech, language, cognition and learning development. The importance of neonatal hearing screening in order to detect and manage children with hearing impairment during the critical period before three years of age can't be neglected. The neonatal hearing screening program at Veterans General Hospital, Taipei, under a cooperation of audiologists, otologists and pediatricians, identified 1885 neonates for hearing loss from September 1990 to August 1991. There were two study groups, a high risk group of hearing impairment and a non-high risk group. We performed hearing screening and followed-up for the failure at initial test using methods including behavioral observation audiometry, auditory brainstem response, tympanogram, pneumatic otoscopy and questionnaire. Approximately 2.7% of neonates were classified as high risk for hearing loss, the incidence of hearing loss was 8% to 14% in this group. The incidence of hearing loss in non-high risk group was 0.11%. If both groups were contained that the incidence of hearing loss was 0.32% to 0.48%, 0.11% with a sensorineural hearing loss, 0.21% to 0.37% with a conductive hearing loss. Both behavioral audiometry (89% false negative rate) and questionnaire (50% return rate) were not effective for screening purposes in this study. Our results also indicated that the most advantage of using a high risk register lay in the fact that only 2.7% of a total population needed to be screened to identify approximately 67% to 78% of hearing-impaired babies. This saved both time and money.