Long-term noise exposure in the workplace is a known cause of hearing loss. There has been limited study on the potential harm related to shock wave lithotripsy (SWL) or intracorporeal devices on patients and operating room personnel.We used a digital sound meter to measure decibel levels in the operating room during several endourologic procedures. The decibel levels were recorded during SWL (Storz SLX-F2), percutaneous nephrolithotomy using single- and dual-probe ultrasonic lithotripters (Olympus LUS-2, CyberWand), and during ureteroscopy using the Versa Pulse Holmium:YAG laser. Findings were compared with the U.S. Department of Labor Occupational Health and Safety Administration and Canadian Centre for Occupational Health recommendations on permissible noise levels in the workplace.The background sound level in the operating room prior to endourologic procedures ranged between 58 and 60 dB. In the SWL control room, 5 m from the source, the mean sound level was 68 dB (range 64-75) during treatment. The mean corresponding decibel level recorded at the patient's head during SWL was 77 dB (range 73-83). Noises produced by intracorporeal lithotripters were recorded at the surgeon's head, 2 m from the source. Measurements of the CyberWand (dual-probe) device revealed a higher mean decibel reading of 93 dB (range 85-102). Noise levels recorded for the Olympus LUS-2 (single-probe) ultrasound and the holmium laser were 65 dB (62 -68) and 60 dB (58-62), respectively.Although we noted that patients and urologists maybe exposed to significant noise levels during endourologic procedures, the duration of exposure is short. This risk appears to be minimal, based on current occupational guidelines, for most operating personnel.