Listeners with cochlear impairment were studied in an ABX pitch-matching paradigm. These listeners showed excellent ability to adjust one sinusoid (X) to match the frequency of another (B), except when a leading tone (A) was present. Pitch shifts induced by the leading tone exaggerate the pitch contrast between tones A and B, even in normal-hearing listeners, but the effect in sensorineural listeners is several times larger and indicates a severe vulnerability of pitch. The degree of pitch distortion does not appear to bear any simple relationship to the degree of hearing loss, or to stimulus amplitudes. The effect is obtained at 'comfortable' listening levels. Vulnerability of pitch, rather than a failure in discriminative capacity, may underlie some of the qualitative perceptual difficulties found in sensorineural hearing impairment.