Psychogenic hearing defects are more common than previously recognized. The disorder is characterized by typical behaviour, audiological signs and symptoms. Patients may show severe hearing losses as evaluated by pure-tone threshold audiometry but can understand usual conversation. Results of audiological examination may be conflicting and suggest a wide range of organic hearing disorders. Other characteristics are dramatic improvement of hearing following sham procedures or placebo medication. Detection of psychogenesis and etiologic factors are of utmost importance for successful therapy. Between 1988 and 1991, 21 children and adolescents (ages 5-16 years) with psychogenic hearing losses were studied. Typical signs as well as diagnostic and therapeutic tools are illustrated in renewal case histories. In-patient diagnosis and treatment are recommended, since improvement was achieved in all patients treated.