Background The purpose of this preliminary study was to explore one potential underlying factor that may contribute to poor reading outcomes: minimal hearing loss. Additionally, we compared decoding and comprehension deficits in students who passed or failed the hearing screening. Method Forty-three school-age students completed a hearing screening and a literacy assessment. Results Fifty-four percent of children with reading impairments failed the hearing screening, compared to only 21% of children with typical reading. Additionally, students who failed the hearing screening were more likely to exhibit decoding deficits; comprehension skills between the hearing screening groups did not differ. Conclusions Thus, children with reading impairments are more likely to fail hearing screenings than children with typical reading, and the deficits of those who fail hearing screenings appear to center on decoding rather than comprehension skills. Supplemental Material https://doi.org/10.23641/asha.12818252