Cisplatin-induced ototoxicity can be partially attributed to excessive reactive oxygen species (ROS) production, and agmatine is well-known for the activation of the phosphatidylinositol 3-kinase (PI3K)/ protein kinase B (AKT) pathway to inhibit ROS production. Whether agmatine could be utilized to alleviate cisplatin-induced ototoxicity is investigated. Cisplatin exposed House Ear Institute-Organ of Corti 1 (HEI-OC1) cells and cochlear explants showed increased ROS production detected by 2'-7'dichlorofluorescin diacetate (DCFH-DA) staining and decreased cell viability detected by Cell Counting Kit-8 (CCK-8) or Myosin 7a staining, which could be reversed by the agmatine pre-treatment. Cisplatin intraperitoneally injected C57BL/6 mice demonstrated damaged auditory function as indicated by distortion products otoacoustic emissions (DPOAE) and auditory brainstem response (ABR) assays, and trans-tympanically administrated agmatine in the left ears could partly prevent the auditory function loss. Mechanistically, down-regulated B-cell lymphoma 2 (Bcl-2) expression, up-regulated Bcl2 Associated x (Bax) expression, and diminished p-PI3K and p-AKT expression were detected in cisplatin-exposed HEI-OC1 cells and cochlear explants, which could be prevented by the pre-treatment with agmatine. Our investigation demonstrates that agmatine pre-treatment could alleviate cisplatin-induced ototoxicity with the activation of PI3K/AKT signaling pathway.