Auditory function was evaluated in nine patients with two metabolic bone disorders, seven with idiopathic osteoporosis (IO) and two with Paget's disease of bone (PD). Five patients with IO and the two with PD were subjectively aware of hearing losses which occurred concomitant with or after the onset of symptoms of their bone disease. Audio-metric thresholds were markedly altered from normal in six of seven patients with IO and in the two with PD when compared with an age-matched patient group without bone disease. Three distinct patterns of hearing loss were observed. Acoustic resistance was elevated in each patient tested indicating some fixation of the ossicular chain. Roentgenographic analysis of temporal bones indicated increased sclerosis of cochlear and vestibular labyrinths in four of seven patients with IO. These results demonstrate that patients with two forms of metabolic bone disorders have decreased auditory function.