We herein report on the hearing improvement obtained after tumor removal in a vestibular schwannoma patient with preoperative severe hearing loss and good otoacoustic emission. Hearing recovery after tumor removal is an uncommon occurrence. As a result, hearing preservation surgery is usually not performed for patients with severe hearing loss. However, patients with a good OAE seem to have a better chance to recover their hearing than those with a poor OAE, even if they have severe hearing loss. As a result, the cochlear function should be evaluated, especially regarding the OAE, before determining the indications for hearing preservation surgery.