BACKGROUND One of the most common pathologies in neonates is hyperbilirubinemia, which is a good marker for damage to the central nervous system. The sensitivity of the auditory system to bilirubin has been previously documented, with much discrepancy in its effects on Auditory Brainstem Response results. Thus the objective of this study was to evaluate the effects of hyperbilirubinemia on Auditory Brainstem Response of neonates treated with phototherapy. METHODS Forty-two term neonates with hyperbilirubinemia, who underwent phototherapy participated in this cross sectional study. The recording of Auditory Brainstem Response was made shortly after confirming that the total serum bilirubin level was greater than 15 µg/dl. Latency of waves I, III, V and inter-peak latencies of the waves were measured. To test the hypothesis about the difference of means between the two groups, continuous variables were compared using either the t-test (normal distribution) or the Mann-Whitney test (non-normal distribution). RESULTS There was a significant increase in the absolute latencies of waves III and V, and I-III and I-V inter-peak latencies of the sample group compared to the control group in both ears (P<0.05). However, wave I absolute latency and III-V inter-peak interval did not show a significant difference between the two study groups (P>0.05). CONCLUSIONS The results of this study underline the importance of the Auditory Brainstem Response Test as an efficient tool for monitoring the auditory brainstem pathway in neonates who are at risk of neurotoxicity and for diagnosing the earliest stages of auditory damage caused by high levels of bilirubin.