Importance: Accurate, efficient, and accessible hearing assessment tools are important for early identification and management of hearing loss. Mobile audiometry embedded in consumer electronics may help overcome barriers to clinic-based care, but independent validation remains critical.

Objective: To evaluate the accuracy, test-retest reliability, and time-efficiency of Apple’s Hearing Test Feature (HTF) compared with reference standard pure-tone audiometry (PTA).

Design: Cross-sectional validation study conducted in 2025.

Setting: Single-center study conducted at a University clinic. PTA was performed in a sound-treated booth. HTF testing occurred in a quiet room simulating a home environment.

Participants: Volunteer sample of 25 adults (mean age 50.1 years [SD 14.2]; 68% female) with self-reported mild-to-moderate hearing loss, recruited via digital advertisements. Each participant contributed 16 thresholds, yielding 400 comparisons to support stable estimation of accuracy/reliability.

Exposure: Participants underwent PTA conducted by an audiologist, followed by two independent HTF assessments (at the beginning and end of the session) using Apple AirPods Pro 2 paired with an iPhone 13.

Main Outcome(s) and Measure(s): Primary outcomes were threshold accuracy compared to PTA and test-retest reliability of the Apple HTF. Test duration was a secondary outcome.

Results: Across 400 threshold comparisons, 86.5% of HTF thresholds were within 10 dB HL of PTA. Root mean square deviation (RMSD) values ranged from 3.3 to 7.9 dB HL (left ear) and 5.8 to 9.7 dB HL (right ear), meeting the minimally acceptable accuracy (RMSD ≤10 dB HL). Test–retest was reliable, with 84.1% of thresholds within 5 dB HL and 96.6% within 10 dB HL. Desired reliability (RMSD ≤6 dB HL) was met at all frequencies except 250 Hz (left ear), which still met the minimum acceptable level. The HTF was significantly faster, with a median duration of 5.5 minutes vs. 10.0 minutes (p < .001).

Conclusions and Relevance: Apple’s HTF demonstrated clinically acceptable accuracy and test-retest reliability, with improved time-efficiency compared to PTA. These findings support its potential for consumer-led hearing monitoring and use in OTC self-fitting hearing aid pathways. Further research should assess inter-device reliability and explore integration with Apple’s Hearing Aid Feature as part of a complete OTC hearing care solution.