A histologic study of sudden deafness resulting from rupture of cochlear membranes, first in the left ear, and then, three years later, in the right ear, in a patient with vertebro-basilar arteriosclerosis is reported. Two healed ruptures were demonstrated on the right side, one in the hook portion of the cochlea, and one in the area of the promontory. The latter was adherent to the saccule, distorting it inferiorly. In the left temporal bone, a healed rupture was demonstrated approximately 5 mm distal to the labyrinthectomy obliteration. Although the patient's vertebro-basilar artery disease and her sudden deafness syndromes are considered separate entities, one must at least consider whether such longstanding vascular insufficiency might predispose to more readily ruptured membranes with sudden pressure changes in the inner ear.