Sensorineural hearing loss (SNHL) is influenced by genetic and environmental factors. This study explores the causal relationships between dietary choices, circulating metabolic biomarkers, and SNHL using Mendelian Randomization (MR) analysis. We utilized summary statistics from genome-wide association studies (GWAS) on dietary choices and metabolic biomarkers as exposures, with SNHL as the outcome. Two-sample MR analysis and mediation analysis were conducted to identify causal links and metabolic pathways. The MR analysis revealed that fish, oily fish, healthy food, and vegetable consumption significantly reduce the risk of SNHL. The mediation analysis further indicated that these protective effects are mediated by the ratios of DHA, omega-3, and polyunsaturated fatty acids to total fatty acids, with DHA mediating approximately 10.57% of the protective effect of oily fish consumption. Significant causal pathways link dietary choices and metabolic biomarkers to SNHL, suggesting that dietary modifications, particularly increasing the intake of fish, healthy foods, and vegetables, could serve as effective preventive strategies against SNHL. This study provides valuable insights into the interplay between diet, metabolism, and hearing health, guiding future preventive strategies.