This article provides an overview of ototoxic medication, as well as different pharmacological and audiological monitoring strategies. Although ototoxic medications play an important role in modern medicine, they also have the capacity to do great harm and lead to significant morbidity. Physicians have to be aware of the potential effects of medication in order to identify patients who are at increased risk of developing ototoxicity. Precaution should be taken to prevent any auditory impairment that might occur through appropriate administration and monitoring. Although some otoprotective substances have been used successfully in certain studies, further trials must be performed to assess their clinical utility. The clinical pharmacist and audiologist form an important part of the ototoxicity management healthcare team.