This paper describes the international education and practice of audiology with the broader aim of proposing possible cost-effective and sustainable education models to address the current situation. Major audiology organizations worldwide were surveyed from February 2005 to May 2007, and organizations from 62 countries (78% of the world population) returned a completed survey. Overall, the results suggested a wide range of professionals providing hearing health care, and 86% of the respondents reported a need for more audiologists. There was also considerable variation in the scope of practice among the different hearing health care professionals, and the minimum education levels of audiologists with similar scopes of practice. The countries surveyed fell into four broad categories in terms of professional resources, and the results highlighted the urgent need for forward planning at both national and international levels. The study highlights options for addressing some of the challenges in educating audiologists and the provision of hearing health care services globally.