Health implications of earpiece use among undergraduate students has a dearth of studies as current literature based in the Nigerian context revealed. Nigerian students have been observed to have a habit of listening to loud music and making phone calls through their earpiece on a regular basis which could cause an implication to their health. It is against this backdrop that this study examined the Awareness and Knowledge of the harmful effects of earpiece use among university undergraduates in Anambra State. The study adopted the survey design while a structured questionnaire was the data collection instrument from a sample size of 370 based on the Krejcie and Morgan method of sample size selection. The study was anchored on the Reasoned Action Theory. The study found out that university undergraduate students in Anambra state are very much aware of the health implications of using earpiece and know that using earpiece can be harmful. They feel there is less sensitization on the health implications of earpiece usage by relevant health authorities. The study therefore concludes that earpiece usage comes with serious health implications which could lead to a serious health challenge on the user, yet in an era of paucity of health campaigns and sensitizations on this subject, the young adult generation takes pride and earns gratification from using earpiece for listening to music and making calls albeit in a high decibel manner. The study therefore recommended that government through its health agencies map out a serious sensitization and campaign strategy towards creating awareness for the youths on the health implications of frequent earpiece usage.