Syphilis was a common cause of progressive or sudden sensorineural hearing loss. After introduction of penicillin, the incidence of syphilis decreased in general population. However, with the prevalence of HIV infection, it's incidence is increasing. Many studies have substantiated the aggressive and rapidly progressive behavior of neurosyphilis, including otosyphilis, in the presence of HIV infection . We report a case of 38-year-old man HIV infected patient with bilateral sensorineural hearing loss and bilateral total vestibular loss caused by otosyphilis which was resistant to treatment.