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Acoustic neuroma (AN) patients who had normal hearing accounted for 7% of all our AN cases. It is important to identify AN patients who have normal hearing but are suffering from tinnitus, dizziness, or vertigo, or a combination of these symptoms (without hearing loss), in order to make an early diagnosis. Patients who experience sudden hearing loss and recover completely should also be thoroughly examined in order to rule out AN. In this article, we describe an investigation of the clinical features and results of hearing preservation surgery in AN patients with normal hearing. The overall hearing preservation rate was 57%. The hearing preservation rate did not depend on the auditory brainstem response (ABR) pattern, tumor size, or the origin of the tumor. We think that patients must be properly informed concerning all aspects of the surgery, including the possibility that hearing and/or facial nerve function cannot be preserved.