Objective: To evaluate auditory function in a group of Egyptian type 1 diabetic children. Methods: This was a cross sectional observational study, which included 40 patients with type 1 diabetes and 40 controls. HbA1, urinary albumin/creatinine ratio, and auditory assessments (including dizziness questionnaire, pure tone audiometry, speech audiometry, tympanometry, and auto-acoustic cochlear emission) were completed for all patients and controls. Mann-Whitney U-test, χ 2 -test and Spearman’s correlation were used for statistical analyses. Results: Assessment of pure tone audiometry revealed that the diabetics had a significantly higher reading in high frequency at 8000 Hz, 16,000 Hz, 17,000 Hz, and 18,000 Hz on the right side and at 4000 Hz, 8000 Hz, 16,000 Hz, 17,000 Hz, and 18,000 Hz on the left side. There was a significantly lower level in speech reception threshold, repetition of words, and masking level of diabetics on the left side. Evaluation of transient otoacoustic emission revealed that diabetics recorded significantly lower signal to noise ratio at 4000 Hz on the right side and at 1000, 1500, 4000, and all Hz on left side. There was significant lower emission amplitude in the right side of the diabetics group at 1500 and 4000 Hz and at 1000, 1500, and 4000 Hz on the left side. Patients with failed otoacoustic emission were significantly higher in disease duration >10 years. Conclusion: Type 1 diabetes is associated with high/extended high frequency hearing loss, more prominent on the left side and with longer disease duration.