The auditory brainstem response (ABR) is a clinical tool to assess the neural functionality of the auditory brainstem. The use of verbal stimuli in ABR protocols has provided important information of how the speech stimuli are processed by the brainstem structure. The perception of speech sounds seems to begin in the brainstem, which has an important role in the reading process and the phonological acquisition speech ABR assessment allows the identification of fine-grained auditory processing deficits, which do not appear in click evoked ABR responses. The syllable /da/ is commonly used by speech ABR assessment due to it being considered a universal syllable and allows it to be applied in different countries with good clinical assertiveness. The speech ABR is a objective, fast procedure that can be applied to very young subjects. It be utilized in different languages and can provide differential diagnoses of diseases with similar symptoms, as an effective biomarker of auditory processing disorders present in various diseases, such as dyslexia, specific language impairment, hearing loss, auditory processing disorders, otitis media, and scholastic difficulties. Speech ABR protocols can assist in the detection, treatment, and monitoring of various types of hearing impairments.