Aims: This study aims to explore the intersection between Aboriginal and Torres Strait Islander songlines and contemporary auditory science, highlighting how traditional listening practices embody a sophisticated understanding of hearing, spatial orientation, and memory. It further seeks to contextualise the cultural implications of hearing loss within Indigenous communities, linking traditional knowledge systems to modern otological care. Methodology: A qualitative review of anthropological, linguistic, and audiological literature was conducted to examine descriptions of songlines, deep listening (dadirri), and sound-based navigation. These were interpreted through modern frameworks of auditory perception, including frequency discrimination, localisation, and cognitive sound mapping. Contemporary public health reports on Indigenous hearing outcomes were also reviewed to assess how biomedical approaches align—or conflict—with traditional sound practices. Results: Songlines emerge as intricate oral maps, encoding geographic and spiritual knowledge through rhythm, pitch, and repetition. These practices demonstrate exceptional auditory acuity and memory integration, comparable to modern concepts in spatial hearing and neuroaudiology. Hearing disruption from otitis media or environmental factors has cascading effects beyond communication—impacting ceremony, storytelling, and cultural transmission. Conclusion: Aboriginal songlines reveal that hearing is not merely a sensory process but a foundation of identity, connection, and survival. Understanding these traditions through an otological lens highlights the need for culturally informed hearing healthcare that respects Indigenous frameworks of listening. This synthesis between ancient sound-based navigation and modern auditory science enriches both clinical practice and our appreciation of the world’s oldest continuous auditory culture.