Background Orthognathic surgery is widely used in treating functional and skeletal problems. Any surgical procedure could cause side effects. Objectives This study aimed to evaluate the potential changes in orthognathic surgery on the hearing function of patients. Materials and methods Thirty-one orthognathic surgery candidates were recruited in this study. Patients underwent either single or double jaw surgery. Pure tone audiometry (PTA), tympanometry, and Eustachian Tube Dysfunction Test (ETFT) were performed postoperatively at 24 h, 6 weeks, and 6 months after surgery. Patients were tabulated based on the type of maxilla and mandibular surgical movements (vertical and horizontal). Results PTA evaluation, based on horizontal or vertical movements, did not show significant differences, although vertical movements resulted in less change in hearing threshold. In other words, no significant changes occurred in patients’ hearing threshold after surgery. No significant difference was also observed between horizontal and vertical movements in the results of tympanometry. Negative changes were found in the results of ETFT in vertical movements, which returned to pre-surgery values in the final test. Conclusions The risk of minor changes in hearing function is probable during the first week after orthognathic surgery, but these negative changes will either totally fade or remain negligible. Patients gave informed consent preoperatively, and reassurance postoperatively is prudent.