This revision article focuses on hyperacusis, a hypersensitivity to sounds of mild or moderate intensity, which occurs in patients with normal hearing due to a gain in the central auditory pathways. It may be more often than expected in patients with otological complaints, presenting in 25 to 40% of patients with tinnitus, for instance. Hyperacusis patients usually refer a marked intolerance to ordinary environmental sounds, such as draining water, refrigerator, washing machine, air conditioning and ring bell among others. In its severe degree, this condition may be quite devastating to the patient. The correct diagnosis is important for an adequate and efficient treatment, which consists in appropriated individual orientation to avoid over protection and in the use of low intensity and constant white noise to reset the subcortical pathways, preferably through noise generators.