Background: Hearing loss (HL) in childhood is a significant disability with severe consequences for educational, cognitive, and social-emotional success. Nevertheless, prevalence estimates for HL in Sub-Saharan Africa (SSA) are based on scarce data. Therefore, we aimed to estimate the prevalence of HL in a sample of primary school children from a rural province of Zimbabwe. Methods: A cross-sectional study was performed on primary school children aged 4–13 years from a rural Zimbabwean province. In the quietest room available, participants underwent audiometry, video otoscopy, and tympanometry. Hearing loss was defined as a pure-tone average > 25 dB. Risk factors of hearing loss were evaluated via a questionnaire. Furthermore, to enable comparison with similar studies, HL prevalence was calculated according to two other commonly used definitions. Results: A total of 451 pupils were included, of which 10.6% (95% CI 7.8–13.5) met the study criteria for HL. Conductive HL (95.1%) was nineteen times more prevalent than sensorineural HL (4.9%). Otitis media was the underlying cause in 40% of all cases of HL. The prevalence of clinically significant HL varied depending on the definition applied, i.e., 0.4% (95% CI -0.2–1.0) in the worst World Health Organisation category as opposed to 4.2% (95% CI 2.4–4.1) in the worst American Speech-Hearing Association category. Conclusions: Hearing loss was common in this sample of primary school children from a rural province in Zimbabwe.