The first case of full recovery from deafness after radical intracapsular removal of a large acoustic neurinoma, more than 4 cm in diameter, is reported. The patient, a 17-year-old woman, had multiple intracranial and intraspinal tumors in addition to bilateral acoustic neurinomas. Radical intracapsular removal is a useful technique to preserve nerves in patients with large acoustic neurinoma. When identifiable evoked potentials are preserved in brain stem auditory evoked potential, hearing preservation should be tried despite preoperative hearing level.