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Objectives: This study aimed to investigate the therapeutic efficacy of combined hyperbaric oxygen therapy (HBOT) and steroid therapy in treating sudden sensorineural hearing loss (SSNHL) Design: This retrospective analysis included 505 patients diagnosed with SSNHL from August 2017 to July 2022. The patients received either a systemic steroid (SS) alone or SS with HBOT. Hearing improvement was evaluated with pure-tone audiometry (PTA). Among the participants, 102 received SS + HBOT, whereas 403 were treated with SS alone. Results: The SS + HBOT group demonstrated significantly better improvement in the PTA threshold averaged across four low frequencies (PTA4) scores (22.7 ± 23.5 vs. 16.2 ± 21.4, P = 0.007) and higher response rates (≥15 dB improvement) and significant response (≥25 dB improvement) (61.8 % vs. 44.4 %, P = 0.002; and 43.1 % vs. 22.6 %, P 50 dB and younger individuals. Conclusions: HBOT improves the effectiveness of SS treatment in SSNHL, with notable benefits for younger patients and those with an initial hearing loss of >50 dB. HBOT exhibited more pronounced effects at lower frequencies. Initiating HBOT within 11 days of the SSNHL diagnosis is recommended, and a regimen of five sessions is indicated for optimal results.