The term ototoxicity is used to refer to temporary or permanent damage to the audiovestibular system as a result of medicines or chemicals. The ototoxic substances may target: - The vestibular system, which is important for balance - The cochlea, which is the organ of hearing - The auditory pathways, which convey signals from these structures to the auditory cortex/vestibular cortex - A combination of these. Although studies from many countries have shown that ototoxicity is not a major cause of hearing loss or balance problems, it is important as it is potentially preventable. It is more prevalent in low- and middle-income countries (LMICs) due to a lack of understanding amongst health workers and insufficient resources to identify improper use of medicines and chemicals. Health workers may not have come across ototoxicity in their training. Laboratories in hospitals may lack the facilities to monitor the blood levels of ototoxic drugs and industrial use of ototoxic chemicals may not be recognised as a cause for concern by those responsible for the care of the workers exposed.