The article summarizes modern ideas about presbycusis in a review form. The widespread and negative impact of hearing impairment on the quality of life of elderly patients leads to the need to study pathogenesis and etiology in order to find new methods of treatment and prevention of this pathology. Various factors have been studied in detail: genetic, epigenetic, and environmental factors leading to the development of presbycusis. The latest data on the pathogenesis and methods of preventing age-related hearing changes are also presented.