Objective To determine the value of the Hearing Handicap Inventory for the Elderly (HHIE)-screening version and the Distortion Product Otoacoustic Emissions testing (DPOAE) in the diagnosis of early presbycusis. Methods Ninety-five elderly patients (51 males and 44 females, over 65 years old, with hearing loss for more than 1 year because of sensorineural hearing loss) admitted in the Hainan Branch of Chinese PLA General Hospital from May 2013 to October 2014 were enrolled in this study. The cohort underwent pure tone audiometry, acoustic impedance tests, DPOAE testing and was surveyed with hearing screening scale HHIE. Results For the 11 patients diagnosed as mild hearing loss by pure tone audiometry, their HHIE scored an average of (30.1±5.0) points, including 1 case ≥43 points [as severe hearing impairment, accounting for 9.1% (1/11)], and the detection rate of DPOAE was 81.8%, with a threshold of (61.3±7.0) dB SPL. For the 23 patients of moderate hearing loss by pure tone audiometry, their HHIE scores were averagely (35.6±4.0) points, including 3 cases ≥43 points [as severe hearing impairment, accounting for 13.0% (3/23)], and the detection rate of DPOAE was 78.3%, with a threshold of (68.3±5.0) dB SPL. For the 34 cases of moderately severe hearing loss by pure tone audiometry, their HHIE scored an average of (39.3±6.0) points, and 12 cases of them had ≥43 points [as severe hearing impairment, accounting for 35.3% (12/34)], and their DPOAE detection rate was 52.9% with a threshold of (71.3±5.0) dB SPL. For the 18 cases of severe hearing loss by pure tone audiometry, their HHIE scored an average of (61.7±2.0) points, all of them were severe hearing impairment, and the DPOAE detection rate was 11.1% with a threshold of (80.4±3.0) dB SPL. For the 9 cases of extremely severe hearing loss by pure tone audiometry, their HHIE scores were (89.7±5.0) points in average, all of them were severe hearing impairment, and the DPOAE detection rate was 0.0%. Conclusion Pure tone audiometry can not fully reflect the degree of hearing impairment in patients with senile deafness. HHIE screening combined with DPOAE testing is of great significance in the early diagnosis of presbycusis.