Offshore wind farms are part of the transition to a sustainable energy supply and both the total numbers and size of wind turbines are rapidly increasing. While the impact of underwater sound related to construction work has been in the focus of research and regulation, few data exist on the potential impact of underwater sound from operational wind farms. Here, we reviewed published sound levels of underwater sound from operational wind farms and found an increase with size of wind turbines expressed in terms of their nominal power. This trend was identified in both broadband and turbine-specific spectral band sound pressure levels (SPLs). For a nominal power of 10 MW, the trends in broadband SPLs and turbine-specific spectral band SPLs yielded source levels of 170 and 177 dB re 1 μPa m, respectively. The shift from using gear boxes to direct drive technology is expected to reduce the sound level by 10 dB. Using the National Oceanic Atmospheric Administration criterion for behavioral disruption for continuous noise (i.e., level B), a single 10 MW direct drive turbine is expected to cause behavioral response in marine mammals up to 1.4 km distance from the turbine, compared to 6.3 km for a turbine with gear box.