Introduction: Noise exposure is a common risk factor for many health adverse effects like hearing impairment, cardiovascular diseases and psychosocial dysfunction. Hypercholesterolemia is suspected to be the main factor for the pathogenesis of prolonged noise-associated cardiovascular extra-auditory effects of occupationally-induced noise. Occupational stress and noise exposure were associated with lowering of total and free testosterone in active male workers which in turn was considered as a risk factor for cardiovascular disease, obesity and many other diseases causing overall mortality. Aim of work: To evaluate the environmental measurement of occupational noise intensity at different units of concrete pipes industry and to assess the effect of occupational noise exposure (either auditory or extra-auditory) on the exposed workers with emphasis on cardiovascular symptoms, serum cholesterol and testosterone levels. Materials and methods: A comparative cross sectional is conducted upon 105 male workers in a company for reinforced concrete pipes at Cairo, Egypt. The study group ages ranged from 24- 60 years. Duration of work ranged from 2- 40 years. The workers are classified into two groups: group (A): 52 workers who are exposed to high level noise ≥ 85dB, and group (B): 53 workers who are exposed to low level noise < 85dB.Both groups were interviewed using specially designed questionnaire with emphasis on occupational history ,cardiac history ,history of hearing impairment and sleep disturbances .Clinical (general and systemic) examination was done. Laboratory investigations were performed including serum total cholesterol level, total and free serum testosterone levels. Results: The prevalence of hearing impairment was significantly higher among workers exposed to noise level above 85dBA (61.5% ) as well as the prevalence of cardiac symptoms as palpitation , ischemic heart diseases and history of catheterization were significantly higher among workers from group (A) (53.8%, 40.4% and 15.4% respectively). The levels of total serum cholesterol were significantly higher among workers exposed to noise levels above 85dBA (odds Ratio = 17.6) while total and free testosterone were significantly lower among the same group. Conclusion: The current study revealed that exposure to chronic occupational noise above 85dBA was associated with hypercholesterolemia that leads in turn to cardiovascular disorders and also associated with low levels of serum testosterone hormone.