Purpose: The current study aimed to determine the mean ambient noise levels within a risk-based newborn hearing screening (NHS) programme. It further aimed to investigate the relationship between the ambient noise levels and the screening outcome. A descriptive, longitudinal, repeated measures, within-subjects design was employed. Three hundred and twenty-five neonates from two public sector hospitals were enrolled in an NHS programme.Methods: These neonates underwent an initial hearing screening in the wards, and were thereafter booked for a repeat hearing screening which was conducted in an outpatient clinic within the hospital setting. Screening included transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs) and automated auditory brainstem response (AABR). The maximum ambient noise levels were measured and recorded for each screening session. Data related to mean ambient noise levels were analysed using descriptive statistics. The independent samples t-test and the Wilcoxon rank sum test were used to determine the association between the ambient noise levels and screening outcomes.Results: Results indicated that the ambient sound levels were significantly higher for ears which referred, compared to ears which passed.Conclusion: Findings from the current study highlight the need for monitoring of ambient noise levels across all screening contexts, and consideration of the inclusion of sound level measurements when planning for hearing screening programmes, particularly for contexts where environmental adaptations may not be possible.