This paper describes an assessment of noise caused by railway traffic in a large high-loaded railway track in Northwest Slovakia.The measurements of noise levels generated by trains passing through residential neighborhoods were taken. Noise maps were also calculated showing noise pollution generated by the train traffic. In addition, the annoyance level and sleep disturbance of residents affected by railway noise were evaluated by a validated questionnaire on a pilot sample of 107 respondents living near the important railway track.The measurements indicated that the noise levels generated by the passage of the train were extremely high especially at night, clearly exceeding the nighttime limits of equivalent sound pressure level established by the Decree of the Slovak Ministry of Health (No.549/2007) (LAeq = 55 dB). Measurements at one point during the night exceeded the limit values of up to 17.4 dB. The residents reported feeling affected by the noise generated by passing trains, which caused irritability, headache, poor concentration, and insomnia. In addition, 19.64% of the residents claimed that nocturnal noise pollution was the most distressing. The results of bivariate analysis showed a higher risk of annoyance especially for railway noise [ORMH = 7.80 (4.02-15.14)] and the noise from industry [ORMH = 3.08 (1.72-5.50)] in the exposed location.The effects of railway traffic on annoyance/sleep and psychosocial well-being were evaluated in a few studies. In accordance with our results the railway noise mostly disturbs sleep and rest of the respondents.The pilot survey showed the importance of sleep and rest disturbance by railway noise and the possibilities of getting worse health condition in the future. Noise abatement measures and strategies should, therefore, be implemented in an effective and manageable way increasing the environmental advantages of rail transport.