The invention discloses a variable-pressure pure-tone audiometry device which comprises a sealing ear cover, an earphone, a hearing meter, an air inflation and deflation device, an MCU controller anda pressure sensor, wherein the earphone and the pressure sensor are both fixed in the sealing ear cover, the earphone is connected with the hearing meter, the air inflation and deflation device is connected with the sealing ear cover and can be used for inflating or deflating the sealing ear cover, the air inflation and deflation device is connected with the MCU controller, and the pressure sensoris connected with the MCU controller. The invention further discloses a variable-pressure pure-tone audiometry method which comprises the following steps: S1, acquiring a pure-tone air-conduction hearing threshold value under normal pressure; S2, setting the test sound intensity; S3, carrying out hearing test under the variable pressure and recording a test result; S4, repeating the steps S2-S3 to obtain a whole-frequency-band test result. According to the invention, a simple method is adopted, and air pressure adjustment can be carried out in a pure tone sounding process, the listening function monitoring is realized and more diagnosis information is provided, and the testing efficiency is improved, a means is provided for improving the accuracy of the listening function test, and a verification tool is also provided for other hearing inspection methods. The device and the method are a novel device and method for conveniently testing the sound transmission state of the middle ear.