The routine to screen 4- and 7-year-old children with audiometry has been studied with regard to its preventive value. Out of 2,330 4-year-olds, 27 children with secretory otitis media (SOM) were treated with myringotomy and 9 of these with grommets as a consequence of identification by screening. One child with unilateral, sensorineural impairment received special teacher's assistance 2 h per week as a consequence of identification by screening. When the same children were screened at the age of 7, 6 children with SOM were treated with myringotomy after identification by screening audiometry. Children with SOM at the age of 4 had impaired hearing at the age of 7, identified by screening, 4 times more frequently than other children. The study suggests that audiometric screening in Sweden does not have important preventive effects on hearing impairments or on sequelae of auditory deprivation.