While systemic steroid therapy is most widely considered as a main treatment for idiopathic sudden sensorineural hearing loss (SSHL), the disadvantages of its use are numerous side effects. Intratympanic steroid injection (ITS) delivers steroids through transtympanic route, hence avoids possible side effects with higher perilymph concentration. We conducted a reviewed 47 clinical studies after an online search of the PubMed databases for the following terms "sudden hearing loss, intratympanic steroid". Although the study settings are varied among reviewed articles, most studies in this review consistently showed some benefit of hearing in salvage cases. In addition, it is suggested that intratympanic steroids are equivalent to systemic steroid therapy as initial treatment for SSHL. In patients with contraindications against the use of systemic steroid, ITS may be considered as valuable option for primary therapy. Further studies are necessary to elucidate the optimal protocol of administration.