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ABSTRACT Background The prevalence of hearing loss and chronic otitis media (COM) varies globally and is reported to be higher in developing countries. Hearing loss and COM may hinder language learning after immigration and thus impede integration into society. The aim of the study was to evaluate the prevalence of hearing loss and COM in immigrants to Sweden. Material and Methods Prospectively collected data regarding the hearing and general health of immigrants attending Swedish language classes were assessed. Participants with hearing loss were followed up with microscopic ear examination, pure tone audiometry including tympanometry, and questions regarding general health and health‐related quality of life. Result In total, 487 participants were included. The mean age was 38.7 years, and the female to male ratio was 3 to 1. The most common countries of origin were Syria (16%), Somalia (13%), and Iraq (10%). Hearing loss was found in 74 of the participants (15.2%) and COM in 11 subjects (2.3%). Participants originating from Somalia had a significantly increased risk of COM, odds ratio (OR) 5.83 (95% CI 1.44–23.63), p = 0.036. Conclusion We found that the prevalence of COM in the study cohort was 2.3% and hearing impairment in adult immigrants to Sweden attending Swedish language classes was 15.2%. Among the male participants, hearing loss was present in 28%. Over 25% of the participants with hearing loss were referred for hearing aid fitting. As learning a new language is crucial to integration into society, we advocate for the inclusion of screening audiometry in the general health check‐up for immigrants. Level of Evidence 3.