This study was designed to describe the level of sound in acute patient care areas. A convenience sample of 25 subjects from four intensive care and two general care units within three hospitals in a large metropolitan area was studied. Continuous decibel levels [dB(A)] and equivalent continuous sound pressure levels [LEQ] were measured for 24 continuous hours. Two 3-hour observations were made to assess the sources of sound, and patients were interviewed to determine their perceptions of sound effects. Continuous high noise levels were found in the larger hospital's open heart recovery room and intensive care units [48.5-68.5 dB(A), 15-minute LEQ], lower levels in the smaller hospital's intensive care units [32.5-57 dB(A)] and varying levels in the general ward areas [34.25-62.5 dB(A)]. Decibel levels generated from equipment reached 90 dB(A) in some instances. Patients' perceptions ranged from content to highly perturbed. Although some sources of noise were not immediately changeable, other were adaptable, preventable, or reducible.