The NIOSH Hearing Loss Simulator is a software training and communication tool for promoting hearing loss prevention. It allows a user or trainer to demonstrate the effects of noise exposure on hearing without experiencing an actual noise-induced hearing loss. Estimates of the effects of different levels of noise exposure are based on the American National Standard Determination of Occupational Noise Exposure and Estimation of Noise-Induced Hearing Impairment, otherwise known as ANSI S3.44. This standard specifies the predicted hearing loss for noise-exposed populations of individuals based on risk factors that include gender, age, sound levels (in A-weighted decibels or dBA), and years of exposure. Algorithms specified in the standard were derived from empirical studies of populations that had no exposure to loud noise and other populations that had experienced various levels and durations of noise exposure. This manual explains the major objectives that can be addressed with the simulator and training scenarios that can be applied to real-life, real worker scenarios. The majority of this guide explains the simulator's functions in detail. Simulator users are encouraged to read this manual while learning how to run the software.