There is much speculation regarding the ear’s immune response. The environment in which we live and breathe is getting ever more complex; aspects such as the percentage of the population with autoimmune conditions are on the rise and, therefore, it is definitely a subject matter that requires further consideration. This review article presents the current known theoretical underpinning of the ear’s immune response on different parts of the ear structure. The ‘expression of inflammatory mediators by cells comprising the inner ear sensory epithelia’ is an interesting consideration. However, of particular interest given aspects such as the incidence of thyroid dysfunction in Ménière’s patients, is the response of the endolymphatic duct and sac. A worthwhile read, though one that yields yet more questions for clinical research than comprehensive answers at this stage.