This case involves a woman in her 70s with a complex history of spinal surgeries and pre-existing left-sided sensorineural hearing loss (SNLH), who underwent elective spondylodesis for failed back surgery syndrome. Postoperatively, the patient complained of sudden onset, profound and painless hearing loss. Otorhinolaryngology (ENT) review confirmed bilateral sensorineural hearing loss. A large dural tear causing cerebral spinal fluid (CSF) leak was diagnosed. The CSF leak failed to heal with conservative management and required subsequent surgical repair. The SNHL was attributed to the drop in CSF pressure causing a disruption of the endolymph/perilymph balance. The patient made a complete recovery after a short course of intravenous steroids. SNHL is a documented but rare adverse event in non-otological surgeries. This manuscript stresses the importance of anaesthesiologists being aware of such a complication in high-risk patients. It also highlights modifiable factors to prevent SNHL and discusses possible treatments.