There are 16 metropolitan statistical areas in the United States with a population of > 4 million for which the New York City estimates might be considered representative. These areas comprised a total population of 80,621,123 in 2012 (U.S. Census Bureau 2010), or 25.6% of the U.S. population. By applying the New York City exposure prevalence estimates of Neitzel et al. (2012) to these 16 largest urban agglomerations, we estimate that at least 72.6 million urban U.S. residents were exposed to annual LEQ(24) levels of > 70 dBA in 2010. By comparison, the U.S. EPA estimated in 1981 that 66 million people, or 33% of the U.S. population (not just urban dwellers), were exposed above the recommended limit (Simpson and Bruce 1981). Applying the 1981 U.S. EPA estimate to 2013 census data, and again assuming no change in noise levels over that time, we estimate that 104 million individuals had annual LEQ(24) levels of > 70 dBA in 2013 and were at risk of NIHL and possibly other noise-related health effects. Unfortunately, given the lack of assessment of noise exposure in health surveillance programs in the United States, it is difficult to evaluate these estimated health impacts against observed health effects, and for some health effects metrics other than the LEQ(24) (e.g., the LDN) are likely more appropriate.