Background: hyperbilirubinemia is one of the most disease in term and preterm neonate. A bilirubin level of more than 85 umol/l (5 mg/dL) manifests clinical hyperbilirubinemia in neonates, since with increase level of bilirubin in body many problems like sclera icterus, yellowing of the face and central dysfunction may be achieved. Unfortunately in Neonatal unit just use otoacoustic emission (OAE) to screening of hearing, but this test only evaluate the cochlear and not evaluate the 8th nerve and central auditory pathway, since central hearing loss easily be miss.And after a times a parent of children because inattention of Infant to sound refer to a pediatrician.Methods: This pilot study conducted with 9 neonate (3 male, 6 female) with hyperbilirubinemia more than 20 mg/dL that had been referred to pediatric audiology clinic of rehabilitation faculty of tehran university of medical science. We use otoacoustic emission (OAE) and behavioral observation audiometry (BOA) to evaluation of auditory system.Findings: among 9 neonates that evaluated with otoacoustic emission (OAE) 6 neonates have perfect OAE, 2 neonate abnormal OAE and 1 neonate in ambiguous range. In behavioral observation audiometry (BOA) only 2 neonates show behavioral auditory response, even with max of intensity, and others haven’t any response.Conclusion: we can conclude that in neonate with hyperbilirubinemia more than 20 mg/dL and absent response in BOA, the OAE test can’t be a sensitive test to predict hearing loss in neonate with hyperbilirubinemia. Since it is essential in Neonatal unit of hospital not use only OAE, also use BOA or auditory brainstem response (ABR) test.