Ocean noise pollution is of special concern for cetaceans, as they are highly dependent on sound as their principal sense. Sound travels very efficiently underwater, so the potential area impacted can be thousands of square kilometres or more. The principal anthropogenic noise sources are underwater explosions (nuclear and otherwise), shipping, seismic exploration by mainly the oil and gas industries, and naval sonar operations. Strandings and mortalities of especially beaked whales (family Ziphiidae) have in many cases been conclusively linked to noise events such as naval maneuvers involving tactical sonars or seismic surveys, though other cetacean species may also be involved. The mechanisms behind this mortality are still unknown, but are most likely related to gas and fat emboli at least partially mediated by a behavioral response, such as a change in diving pattern. Estimated received sound levels in these events are typically not high enough to cause hearing damage, implying that the auditory system may not always be the best indicator for noise impacts. Beaked whales are found in small, possibly genetically isolated, local populations that are resident year-round. Thus, even transient and localized acoustic impacts can have prolonged and serious population consequences, as may have occurred following at least one stranding. Populations may also be threatened by noise through reactions such as increased stress levels, abandonment of important habitat, and “masking” or the obscuring of natural sounds. Documented changes in vocal behavior may lead to reductions in foraging efficiency or mating opportunities. Responses are highly variable between species, age classes, behavioral states, etc., making extrapolations problematic. Also, short-term responses may not be good proxies of long-term population-level impacts. There are many examples of apparent tolerance of noise by cetaceans, however. Noise can also affect cetaceans indirectly through their prey. Fish show permanent and temporary hearing loss, reduced catch rates, stress, and behavioral reactions to noise. Management implications of noise impacts include difficulties in establishing “safe” exposure levels, shortcomings of some mitigation tools, the need for precaution in the form of reducing noise levels and distancing noise from biologically important areas, and the role of marine protected areas and monitoring in safeguarding cetaceans especially from cumulative and synergistic effects.