Congenital cytomegalovirus (cCMV) is the primary cause of non-genetic infantile sensorineural hearing loss (SNHL).  The global prevalence is 0.64%, with a 17-20% risk of persistent sequelae in affected children. Patients with cCMV require sophisticated and multidisciplinary management, which includes clinical, laboratory, and instrumental examinations from infancy to school age. In recent years, significant progress has been made in preventing infection-related complications, including the effectiveness of antiviral treatments given during pregnancy to stop vertical transmission, the relationship between the stage of pregnancy and symptom severity, and advanced research into a cytomegalovirus vaccine. These developments have led to updates and adaptations of existing guidelines to better suit new circumstances and management needs. This aims to facilitate early infection diagnosis, implement therapeutic and rehabilitative strategies, and ensure proper monitoring of children’s development during their early years. Management of hearing loss caused by cCMV primarily emphasizes early detection and timely intervention. Newborn hearing screening programs, such as those using transient evoked otoacoustic emissions (TEAOE), alongside targeted cCMV testing in high-risk groups, play a crucial role in identifying children at risk. For infants diagnosed with hearing loss, early treatments—including hearing aids, cochlear implants, and speech therapy—can enhance outcomes and promote the development of language and communication skills.

The author aims to highlight the challenges and recommendations regarding this topic in Italy, with a focus on early rehabilitation and audiological follow-up.