The article discusses the actual problem of professional hearing loss in members of the flight professions of civil aviation in Russia. The indices of this disease amounted of one-third of the prevalence rate values concerning occupational diseases of the hearing organ among all workers of “noise” professions, are registered with the highest frequency in pilots and aircraft commanders and have no tendency to decrease. As the only occupational disease among the persons of the flight professions of the main airlines of the Russian Federation, the persistent sensorineural hearing loss has not only medical but also socio-economic aspects. It is registered in working-age persons lost their professional aptitude. The main revealed causes of the gain of indices of the hearing loss in professional pilots are: the insufficient qualification of medical workers on the issues of early diagnosis of the negative impact of noise on the hearing organ; the lack of regulated criteria for the diagnosis and examination of the relationship between the hearing loss and the occupation; insufficiently clear algorithms of departmental logistics in the examination of occupational diseases of the hearing organ. The ways of optimization of the problem are shown as follows: the development and implementation of the method of speech perception in the conditions of competing the in-cab noise of the aircraft; objective criteria for decision-making on admission/non-admission to the flight work; adequate assessment of the indices of the in-cab noise and sound pressure arising in the aircraft headset during speech radio exchange; mandatory compliance with the requirements of accounting for the data of the Protocol of acoustic load for the entire period of the flight activity, with the indication of noise-protective characteristics of the used airguns in the implementation of the examination of the communication of the disease of the hearing with the profession.