Objective: Chloral Hydrate is the most commonly used sedative for Auditory Brainstem Response (ABR) test. The aim of this study was to retrospectively analyze the safety and effectiveness of Chloral Hydrate in patients undergoing ABR tests through a single-center and large sample size cross-sectional study. Methods: Data were collected from December 2015 to March 2022, which included 7,176 ABR tests (6,106 patients). Basic information was collected, then telephone follow-up was conducted for patients with two or more consecutive tests less than 60 days, and administration method, failure performance, and adverse events were collected. Total sedation failure rate, sedation failure rates in different age groups (≤0.5 years, 0.5-3 years, 3-12 years, ≥12 years) and incidence of adverse events were calculated. Results: A total of 4,967(69.21%) ABR tests were younger than 3 years of age. The sedation failure rate was 3.11% with a Chloral Hydrate dose of 30 mg/kg of weight, which ranged from 1.44% to 4.31% in different age groups. In the sedation failure tests, insufficient sedation was found in 74.44% of the tests. The incidence of adverse events was 0.35%, with most commonly vomiting. Conclusion: The sedation failure rate and the incidence of adverse events in this study are relatively low compared with other previous studies, and Chloral Hydrate can be considered a safe and effective sedative with the permissible dose. However, there were still many patients who failed to complete the test due to insufficient sedation (mostly infants and children), which imply that alternative sedatives with easier preparation process are needed.