The impedance audiometry has recently been essential to clinical audiology. This study was designed to observe the clinical value of ipsilateral and contralateral reflex HTL. To find it out, the ipsilateral and contralateral reflex HTL was measured in 54 patients, of whom 22 had unilateral conductive hearing loss than 10dB A-B gap, 28 had sensorineural hearing loss and 4 had peripheral facial nerve paralysis above the level of nerve of stapedius muscle. As a control group, ipsilateral and contralateral reflex HTL was measured in 20 normal individuals. Stapedial reflex patterns were analyzed and normal threshold in control group was calculated. The results were as follows; 1) The normal stapedial reflex threshold was 81.8dB HL (ANSI, 1969) in ipsilateral stimulation and 84.8dB HTL in contralateral stimulation. There was no significant difference between ipsilateral and contralateral reflex thresholds statistically. 2) In conductive hearing loss, vertical pattern was identified in 90.9% of cases. 3) In sensorineural hearing loss, diagonal pattern was identified in 81.8% of cases. 4) There was no false positive result between conductive and sensorineural hearing loss. 5) In peripheral facial nerve palsy, vertical pattern was identified in all cases.