Rabbits were exposed to 100 dB pure-tone sound at 2 kHz for 2 h. Electron microscopy was used to study the relationship between changes in the outer hair cells, afferent nerve endings and efferent nerve endings. There was no relationship found between the degree of changes produced in the afferent nerve endings and that the outer hair cells. However, there was a relationship demonstrable between the degree of changes seen in the efferent nerve endings and the infranuclear region of the outer hair cells. These findings show that acoustic trauma will damage most the infranuclear region of the outer hair cells, while efferent nerve endings are injured next and least affected are afferent nerve endings.