This work presents an integrated look at research suggesting that many ototoxic and ototraumatic reactions in the inner ear from drugs and trauma (noise) can be prevented or reduced with pharmacological interventions. The papers, by international authorities, address both the basic science background and the clinical applications of new therapies involving neurotrophins, free-radical scavengers, and other compounds that reduce the risk of hearing loss. A contextual framework is provided by three tutorial papers on free-radical scavengers, neurotrophins, and the role of the kidney in ototoxic reactions.