The objective of this study was to estimate the prevalence and evaluate the associated risk factors of the noise-induced hearing threshold shift (NITS) in the US adult population based on the National Health and Nutrition Examination Surveys (NHANES). The study population consisted of 5,418 individuals aged 20-69 years who had complete audiologic data from the NHANES database. Stringent criteria were used to define NITS. Prevalence of unilateral, bilateral, and total NITS and their association with several socio-demographic and hearing-related factors were evaluated. The prevalence of unilateral, bilateral, and total NITS was 9.4, 3.4 and 12.8%, respectively. Prevalence of bilateral NITS was higher in subjects with older age, male gender, white (non-Hispanic) and Hispanic ethnicities, education level less than or equal to high school diploma, married/living with partner status, Mexico as country of birth, service in armed forces, smoking history, diabetes, and different kinds of noise exposure. Odds of NITS were only higher in older people, males, and smokers. This study provides comprehensive information on the prevalence of NITS in the US adult population and its associated risk factors. More targeted interventions may be done for educational, preventative, and screening purposes. © 2012 Springer-Verlag.