ABSTRACT Introduction: Ototoxic due to kanamycin which resulting sensorineural hearing loss is one of the effects of kanamycin. Antioxidant treatment could prevent the effects of ototoxic. Aim: To compare the effectiveness of Ginkgo Biloba and alpha-tocopherol on prevention incidence of ototoxic due to kanamycin for MDR TB patients. Method: An experimental study in dr. Hasan Sadikin Hospital on July - October 2016, followed by 32 subjects were divided into two groups of patients, 16 subjects were given Ginkgo Biloba (EGB 761), and 16 subjects were given alpha-tocopherol. Examination of ototoxic by using the audiogram and DPOAE. Statistical analysis for this study using the chi-square test. Interpretation of the results of hypothesis testing based on the value of p <0.05. Result: Subjects in group Ginkgo Biloba experience less in hearing loss than alpha-tocopherol group after three weeks post-treatment based on an audiogram (p = 0.048) and DPOAE at a frequency of >8-10 kHz(0.001) and >6-8 kHz (0.014). After four weeks post-treatment group EGB 761 on DPOAE examination less experienced hearing loss at a frequency of >8-10 kHz (0.000) and >6-8 kHz (0.022). Conclusion: Ginkgo Biloba is more effective in preventing ototoxic due to kanamycin in patients with MDR TB than alpha-tocopherol. Giving Ginkgo Biloba can be used as therapy protocols in preventing sensorineural hearing disorders in patients with MDR TB who treated with kanamycin.