Background: Limited research has examined the role of school health personnel in the prevention and early identification of hearing impairment. Purpose: This study assessed high school health teachers' perceptions and teaching practices regarding hearing loss conservation. Methods: A 26-item survey based on selected components of the health belief model and self-efficacy was developed on hearing loss in students and their teaching practices regarding hearing loss conservation. A national random sample of 600 health teachers was obtained from the US Department of Education. Results: A 3-wave mailing was used to achieve a 47% response rate ("n" = 281). One in 7 (15%) health teachers felt very confident in providing information regarding noise-induced hearing loss and 9% felt very confident in providing referral for students. Common hearing loss prevention topics taught were potential damaging effects of music/other sounds (30%), anatomy and physiology of hearing (16%), impact of hearing loss (15%), and sources of personal protection (15%). Discussion: Results suggest that more training and information on hearing is needed and desired by health educators. Translation to Health Education Practice: School health teachers need to assess threats to adolescent hearing loss and incorporate hearing loss conservation into the curriculum and serve as a resource person to others regarding this topic.