A review of the last 10 years of research on impulse noise reveals certain insights and perspectives on the biological and audiological effects of exposures to impulse noise. First, impulse noise may damage the cochlea by direct mechanical processes. Second, after exposure to impulse noise, hearing may recover in an erratic, nonmonotonic pattern. Third, even though the existing damage-risk criteria evaluate impulse noise in terms of level, duration, and number, often parameters such as temporal pattern, waveform, and rise time are also important in the production of a hearing loss. Fourth, the effects of impulse noise are often inconsistent with the principle of the equal energy hypothesis. Fifth, impulse noise can interact with background continuous noise to produce greater hearing loss than would have been predicted by the simple sum of the individual noises.