AbstractHearing impairment is a global health problem with a high socioeconomic impact. Damage to auditory hair cells (HCs) in the inner ear as a result of aging, disease, trauma, or toxicity, underlies the majority of cases of sensorineural hearing loss. Previously we demonstrated that the Ca2+‐sensitive neuropeptide, somatostatin (SST), and an analog, octreotide, protect HCs from gentamicin‐induced cell death in vitro. Aminoglycosides such as gentamicin trigger a calcium ion influx (Ca2+) that activates pro‐apoptotic signaling cascades in HCs. SST binding to the G‐protein‐coupled receptors (SSTR1‐SSTR5) that are directly linked to voltage‐dependent Ca2+ channels inhibits Ca2+ channel activity and associated downstream events. Here, we report that the SST analog pasireotide, a high affinity ligand to SSTRs 1–3, and 5, with a longer half‐life than octreotide, prevents gentamicin‐induced HC death in the mouse organ of Corti (OC). Explant experiments using OCs derived from SSTR1 and SSTR1and 2 knockout mice, revealed that SSTR2 mediates pasireotide's anti‐apoptotic effects. Mechanistically, pasireotide prevented a nuclear translocation of the Ca2+‐sensitive transcription factor, nuclear factor of activated T cells (NFAT), which is ordinarily provoked by gentamicin in OC explants. Direct inhibition of NFAT with 11R‐VIVIT also prevented the gentamicin‐dependent nuclear translocation of NFAT and apoptosis. Both pasireotide and 11R‐VIVIT partially reversed the effects of gentamicin on the expression of downstream survival targets (NMDA receptor and the regulatory subunit of phosphatidylinositol‐4,5‐bisphosphate 3‐kinase, PI3K). These data suggest that SST analogs antagonize aminoglycoside‐induced cell death in an NFAT‐dependent fashion. SST analogs and NFAT inhibitors may therefore offer new therapeutic possibilities for the treatment of hearing loss.image