Each day in the life of a young child with an undetected hearing loss is a day without full access to language. When hearing loss goes undetected, the resulting language deficits can become overwhelming obstacles to literacy, educational achievement, socialization, and school readiness. Several programs, such as Head Start, Early and Periodic Screening, Diagnosis and Treatment, and Part C of the Individuals with Disabilities Education Act, are responsible for providing hearing screening to many young children nationwide. These programs have typically had to rely on subjective hearing screening methods. Otoacoustic emissions technology, used widely in hospital-based newborn screening programs, is beginning to be recognized as a more practical and effective alternative when screening children from birth to 3 years of age. Successful otoacoustic emissions screening in early childhood settings is dependent on consultation from an experienced pediatric audiologist, selection of appropriate equipment, adherence to an appropriate screening and follow-up protocol, and access to training and follow-up technical assistance. When these elements are present, children with a wide range of hearing health conditions can be identified in a timely manner.