Hair cells of the vertebrate inner ear are mechanosensors that detect sound, gravity and acceleration. They have a specialized cytoskeleton optimized for the transmission of mechanical force. Hair cell defects are a major cause of deafness. The cloning of disease genes and studies of model organisms have provided insights into the mechanisms that regulate the differentiation of hair cells and their cytoskeleton. The studies have also provided new insights into the function of receptors such as integrins and protocadherins, and cytoplasmic proteins such as Rho-type GTPases and unconventional myosins, in organizing the actin cytoskeleton.