<p>This review highlights advances in inner ear organoids (IEOs) as a novel platform for drug screening and disease modeling, particularly for hearing loss. IEOs, derived from embryonic stem cells, induced pluripotent stem cells, or tissue-specific progenitors, provide a physiologically relevant alternative to traditional animal models. Significant progress has been made in utilizing various cell sources, extracellular matrix materials such as Matrigel and hydrogels, and methods for controlling microenvironments through biochemical and biophysical signals. Applications of IEOs in drug screening, disease modeling, and personalized medicine enable exploration of hearing loss mechanisms and therapeutic testing. However, challenges remain, including the incomplete maturation of cochlear cells and difficulty replicating <i>in vivo</i> environments. Future research should focus on optimizing IEO generation, incorporating microfluidic technologies, and advancing high-throughput screening to enhance drug discovery and clinical translation.</p>