We review the history of neurotrophins in the ear and the current understanding of the function of neurotrophins in ear innervation, development and maintenance. Only two neurotrophins, brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3), and their receptors, tyrosine kinase B (TrkB) and TrkC, appear to provide trophic support for inner ear sensory neuron afferents. Mice lacking either both receptors or both ligands lose essentially all sensory innervation of targets in the vestibular and auditory systems of the ear. Analyzes of single mutants show less complete and differential effects on innervation of the different sensory organs within the ear. BDNF and TrkB are most important for survival of vestibular sensory neurons whereas NT-3 and TrkC are most important for survival of cochlear sensory neurons. The largely complementary roles of BDNF to TrkB and NT-3 to TrkC signaling do not reflect specific requirements for innervation of different classes of hair cells. Most neurons express both receptors. Instead, the losses observed in single mutants are related to the spatio-temporal expression pattern of the two neurotrophins. In an area where only one neurotrophin is expressed at a particular time in development, the other neurotrophin is not present to compensate for this absence, resulting in death of neurons innervating that region. Decisive evidence for this suggestion is provided by transgenic mice in which the BDNF coding region has been inserted into the NT-3 gene, resulting in expression of BDNF instead of NT-3. The expression of BDNF in the spatio-temporal pattern of NT-3 results in survival of almost all neurons that are normally lost in the NT-3 mutant. Thus, BDNF and NT-3 have a high level of functional equivalence for inner ear sensory neuron survival. Further analysis of the patterns of afferent fiber losses in mutations that do not develop differentiated hair cells shows that the expression of neurotrophins is remarkably strong and can support afferent innervation. Indeed, BDNF may be one of the earliest genes expressed selectively in hair cells and it appears to be regulated somewhat independently of the genes needed for hair cell differentiation.