Completion of an audit loop assessing vestibular schwannoma screening practice in a sub-regional ENT centre shows good agreement between the guidelines given and indications used for selecting patients to undergo screening MRIg. The proportion of cerebellopontine angle tumours diagnosed is consistent with other reports from the United Kingdom. During the audit period the proportion of patients screened because of unilateral tinnitus increased, but not beyond a reasonable estimate of the proportion that could expect to be screened because of this symptom. There was a reduction in the number of inappropriate scan requests after introduction of a guideline reminder. During the initial period after introducing screening guidelines there is increased screening activity, but this plateaus at a steady level.