Given that the medial olivocochlear efferent system reduces the amplitude of otoacoustic emissions (OAE), the aim of this study was to establish whether such a pathway is affected in women with migraine and phonophobia by means of OAE suppression testing. In this prospective case-control study, 55 women (29 with migraine and phonophobia and 26 healthy women) were subjected to transient-evoked otoacoustic emission (TEOAE) testing at frequencies from 1 to 4kHz. The amplitudes of the TEOAE response before and after exposure to contralateral noise and the magnitude of TEOAE suppression were assessed. The average TEOAE amplitudes in conditions with and without exposure to contralateral noise were not significantly different between the groups. However, the magnitude of TEOAE suppression was lower in the group with migraine; that difference was only statistically significant for frequencies 1 and 1.5kHz (p=0.042 and p=0.004, respectively). In this study, women with migraine and phonophobia exhibited deficits in OAE suppression, which points to a disorder affecting the medial olivocochlear efferent system.