Objective To investigate the clinical efficacy and safety of combined administration of Wuling capsule and citicoline sodium capsule in managing sudden sensorineural hearing loss among elderly patients. Methods The patients were randomly assigned to the control group （n = 72） and treatment group （n = 71） using a random number table method. Both groups received oral administration of mecobalamin at a dosage of 0.5mg three times daily， as well as oral intake of ginkgo biloba leaves at a dosage of 2 g three times daily. In addition， the control group also took citicoline sodium capsules orally at a dosage of 0.1 g three times daily. On the basis of the control group， the treatment group was additionally administered Wuling capsules orally at a dosage of 0.99 g three times daily. Both groups underwent one month of treatment for observation purposes， during which their hearing condition， blood viscosity， inner ear microcirculation， peripheral blood cytokines， clinical efficacy and adverse drug reactions were compared. Results The total effective rate of the treatment group and control group was 84.51% （60/71） and 68.06% （49/72）， respectively， with a significant difference observed （P < 0.05）. Following treatment， the pure tone hearing thresholds in the treatment group were measured at （40.03 ± 5.04） dB， while those in the control group were recorded as （45.25 ± 6.21） dB； for high frequency region listening levels， values of （45.27 ± 6.05） dB and （50.01 ± 7.69） dB were obtained for the treatment and control groups respectively； similarly， low frequency region listening levels were found to be （44.21 ± 5.47） dB for the treatment group and （49.32 ± 6.24） dB for the control group. Following treatment， the plasma viscosity was （1.21 ± 0.19） and （1.58 ± 0.24） mPa·s， the high tangential viscosity of whole blood was （3.59 ± 0.52） and （4.12 ± 0.61） mPa·s， the low tangential viscosity of whole blood was （5.83 ± 0.84） and （6.52 ± 0.91） mPa·s， the diameter of the internal auditory artery was （1.12 ± 0.15） and （0.96 ± 0.11） mm， the diameter of anterior inferior cerebellar artery was（1.35 ± 0.18）and（1.19 ± 0.15）mm， calcitonin gene?related peptide concentration in plasma was（386.92 ± 40.02）and（354.21 ± 36.47）ng/mL， soluble vascular intercellular adhesion factor?1 concentration in plasma was（132.14 ± 18.96）and（156.34 ± 21.32） ng/mL， with statistically significant differences observed （P < 0.05）. There were no adverse reactions in both groups during treatment. Conclusion The combination of Wuling capsule and citicoline sodium capsule exhibits a significant therapeutic effect in the management of senile sudden deafness， leading to improvements in hearing ability， blood viscosity， inner ear microcirculation， and peripheral blood cytokine secretion.