All sound in the environment accesses the brain by way of the auditory nerve. This nerve is primarily composed of neurons with myelinated axons that innervate inner hair cells of the cochlea. In order to make sense of sound, neural activity must be closely linked in time to acoustic events. The auditory system has mechanisms to accomplish this task that will be discussed in this presentation. Each auditory nerve fiber forms a giant terminal in the brain with many synapses, and these terminals, called endbulbs of Held, have been observed in every land vertebrate examined to date. I will explore their specializations in hearing, their pathologic reactions to deafness, and their salvation by cochlear implants.