During treatment of inner ear diseases, the blood-cochlear barrier limits the drug delivery into the cochlea. Intratympanic drug injection for inner ear diseases is a safe procedure where drugs reach high concentrations in the cochlea and systemic side effects are minimized. This paper reviews the updated status of intratympanic drug injections for the treatment of inner ear disease. Intratympanic drug injection is an effective procedure for the control of inner ear disorders such as M？ni？re''s disease and sudden sensorineural hearing loss. Although the effect of intratympanic injection on tinnitus and noise-induced hearing loss is open to discussion, its indications could be extended, like as drug, gene, and cell-based therapy.