Abstract: Objective To understand the usage of earphone in college students and its relationship with noise-induced hearing impairment.Methods We took stratified multi-stage random sampling method to select 3 824 students for a questionnaire survey.We investigated the demographic characteristics, the usage of earphone, and the occurrence of noise induced hearing impairment among the students.Results The frequency of earphone usage among the college students was 99.8% and 28.0% of the students had noise-induced hearing impairment.The proportion of students with chronic tinnitus, dizziness/nausea, and hearing loss were 13.4%, 8.2%, and 10.1%.Logistic regression analyses showed that the risk factors of hearing impairment were earphone brand, the type of earphone, the volume of earphone, and using earphone everyday.The protective factor was being female.Conclusion The use of earphone is prevalent among college students and unsuitable usage of earphore is the major factor for noise-induced hearing impairment among the students.