Otosclerosis is a disease of unknown origin, pathologically due to primary limited bone resorption in the bony vagus and replaced by vascularized spongy bone proliferation, hence the term “sclerosis”. When the oval window is invaded, it can cause fixation of the stapes and loss of sound transmission, resulting in progressive hearing loss. The incidence of otosclerosis has a great relationship with ethnicity, with a high incidence in Caucasians, the lowest incidence in Blacks, and a yellow incidence in between. The age of onset is more common in young and middle-aged people. Otosclerosis is a lesion of the bony ear capsule and is the most common cause of progressive transonic deafness in adults with normal tympanic membranes. The most effective treatment for otosclerosis is currently primarily surgical. A small hole is made through microsurgery in the immobilized stapes floor and an artificial stapes is implanted to improve hearing, and most patients experience significant improvement in hearing after surgery. However, surgery does not eliminate the pathological process of otosclerosis. According to the analysis of the results of previous surgical patients at 301 Hospital, the rate of hearing loss after stapes implantation is much slower than that of patients who have not undergone surgery, indicating that stapes surgery can slow down the development of hearing in patients with otosclerosis. Therefore, patients with otosclerosis who have a hearing loss of 30 dB or more should have stapes implantation as early as possible. The unsatisfactory hearing improvement after stapes implantation is often related to the dislocation of the implanted stapes and the inappropriate length of the stapes during surgery. However, it is certain that the majority of patients who have undergone stapes implantation by experienced surgeons will have a significant improvement in hearing after surgery. Therefore, the first choice for patients with otosclerosis should be stirrup implantation, except for those whose hearing loss has reached a significant mixed deafness. Those with poor hearing improvement after surgery may be considered for hearing aids or vibro-acoustic bridge (VSB) implantation depending on the degree of hearing loss.