Aim: The study aims to assess the threshold shift in sensorineural acuity level (SAL) test and bone conduction speech recognition threshold (BC _SRT) in mixed and sensorineural hearing loss. Background: The diagnosis of moderate mixed hearing loss and sensorineural hearing loss is unclear when the air-bone gap (ABG) is at 15 to 20 dB. The study was designed to arrive at the accurate diagnosis of moderate mixed hearing loss and sensorineural hearing loss. Case description: The study includes five participants diagnosed with bilateral normal hearing (n = 1), bilateral conductive hearing loss (n = 1), bilateral sensorineural hearing loss (n = 1), and those with bilateral moderate loss with an ABG of 15 to 20 dB (n = 2). Conventional pure tone audiometry, speech audiometry, immittance, reflexes, and distortion product otoacoustic emission were administered. Conclusion: The BC_SRT was almost the same in confirmed normal hearing and conductive hearing loss participants because their BC sensitivity was within the normal limit. BC_SRT was high in individuals with sensorineural hearing loss and mixed hearing loss. In addition, the amount of threshold shift in SAL was taken into consideration for the diagnosis. Clinical significance: The amount of threshold shift in the SAL test with accompanying BC_SRT concludes that the presence and absence of infection in the middle ear thereby lead to an accurate diagnosis.