Deafness is an invisible disability that may often go undetected until school age, especially in children with no additional disabilities. It affects the social, emotional and cognitive development of an individual. However, this can be overcome through early identification and intervention, for which a screening programme is mandatory. But choosing any option needs realistic assessment of the magnitude of the problem in terms of prevalence as well as the risk factors operating in that specific context. So this study was performed to plan future neonatal screening programmes at Medical College Hospital, Thiruvananthapuram. The study was conducted on 402 babies born at SAT Hospital, Medical College, Thiruvananthapuram. The prevalence of neonatal hearing loss was found to be 0.8%. Craniofacial anomalies, family history of permanent childhood hearing loss and congenital infections were found to be the significant risk factors for hearing loss.