The present study was designed to estimate the prevalence of hearing impairment among the elementary school pupils. The portable tone audiometer in conjunction with otoscopy was used to examine 2.200 children aged from 6 to 9 years attending 12 elementary schools in the city of Sana. The children with negative results of the tests were referred to the University Clinic for the more comprehensive examination. Risk factors were revealed by the questionnaire study involving the parents. As many as 11.6% of the total number of children failed to pass the test. Their number decreased to 10.6% after cleaning the external auditory canal. Conductive hearing impairment was the commonest pathological condition while exudative otitis was its most frequent cause (6% of all cases). The prevalence of hearing impairment among the elementary school pupils in Yemen was shown to exceed that in the developed countries. The high risk of development of this pathology is attributable to the low socio-economic living standards. The importance of audiological screening of elementary school pupils is emphasized.