In May 2003, the National Institute for Occupational Safety and Health and the National Hearing Conservation Association cosponsored the Best Practices Workshop on Impulsive Noise and its Effects on Hearing. The workshop aimed to bring together the leading international experts on impulsive noise from labor, industry, and government an overview of the current state of the art concerning the effects of impulse noise on the auditory system, to develop strategies for the measurement and characterization of impulsive noise, and to identify specific goals and future research priorities. The workshop consisted of a plenary session on the first day and three working group sessions. This paper summarizes the main results of the workshop. Key issues identified by the workshop: (1) need for instrumentation and standards to accurately measure and characterize impulsive noise, (2) need to define impulsive noise metrics and apply animal modeling to humans, (3) characterizing the effect of hearing protection devices on impulse noise in relation to hearing loss, and (4) understanding hearing loss from occupational versus non-occupational exposure.