Chemotherapy-induced ototoxicity, particularly associated with platinum-based agents such as cisplatin, presents a significant clinical challenge, often resulting in irreversible hearing loss. The onset and severity of ototoxicity are influenced by several factors including genetic susceptibility. Pre-emptive pharmacogenomic testing can offer the potential to identify patients at higher risk of ototoxicity prior to treatment initiation. This knowledge could guide precision dosing strategies, selection of alternative therapies, and implementation of otoprotective measures. However, the clinical utility of these genetic markers remains under investigation, with a need for prospective validation and integration into clinical decision-making frameworks. This presentation will focus on genetic factors that have been associated with chemotherapy induced ototoxicity.