OBJECTIVE： To observe therapeutic efficacy and safety of batroxobin in the treatment of senile sudden deafness. METHODS： Totally 102 senile patients with sudden deafness were randomly divided into control group （51 cases） and observation group （51 cases）. Control group was given routine treatment as Ginkgo biloba extract injection 105 mg+Dexamethasone sodium phosphate injection 30 mg+Methotrexate tablets 6 mg orally. Based on control group， observation group was additionally given Batroxobin injection 10 BU added into 0.9％ Sodium chloride injection 100 mL intravenously， running out within 1 h， every 2 days， and then given 5 BU added into 0.9％ Sodium chloride injection 100 mL intravenously， running out within 1 h. Both groups were treated for 10 d. Clinical efficacy， hearing recovery time， ear drowsiness disappearance time， dizziness disappearance time and tinnitus disappearance time of 2 groups were observed. The levels of pure tone threshold， plasma specific viscosity （ns）， high shear rate of whole blood viscosity （nbh）， low shear rate of whole blood viscosity （nbl）， hematocrit （HCT）， erythrocyte sedimentation rate （ESR）， Fb， endothelin （ET） and nitric oxide （NO） were observed before and after treatment as well as the occurrence of ADR. RESULTS： The total response rate of observation group was significantly higher than that of control group； hearing recovery time， ear drowsiness disappearance time， dizziness disappearance time and tinnitus disappearance time were significantly shorter than control group， with statistical significance （P＜0.05 or P＜0.01）. Before treatment， there was no statistical significance in the levels of pure tone threshold， ns， nbh， nbl， HCT， ESR， Fb， ET and NO between 2 groups （P＞0.05）. After treatment， the levels of pure tone threshold， ns， nbh， nbl， HCT， ESR， Fb and ET in 2 groups were significantly lower than before； the observation group was significantly lower than the control group. The levels of NO in 2 groups were significantly higher than before； the observation group was significantly higher than the control group， with statistical significance （P＜0.01）. During treatment， no obvious ADR was found in 2 groups. CONCLUSIONS： Based on routine treatment， batroxobin is effective in the treatment of sudden deafness in the elderly， can effectively relieve the symptoms， improve the recovery of local blood flow and inner ear microcirculation disturbance with good safety.