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The purpose of this study was to determine the prevalence of undiagnosed hearing loss in adults in two busy primary care rural health centers.Using Otoacoustic Emissions (OAE) testing, participants were screened for hearing loss by trained personnel. Participants were those who presented to the primary care provider with complaints other than hearing loss or ear problems.Of the 86 participants, 48.8% were found to have failed OAE testing, indicating some type of undiagnosed hearing loss. The average age of the participants was 49.27 years, yet nearly half had hearing loss. This finding makes hearing screening in the adult population, other than the elderly, an important issue.Hearing loss affects over 40% of the adult population. Undiagnosed and untreated hearing loss can be associated with depression, decreased social activities, and low self-esteem. The project identified the need for routine hearing screening and thus may become the foundation for the development and implementation of a hearing-screening program for primary care. The primary care nurse practitioner needs to incorporate hearing screening into the exam for early identification and for proper referral.