This is a retrospective study on the effects of acute acoustic trauma on the hearing thresholds of 225 military personnel. The main symptom after acute acoustic trauma due to firearm use was tinnitus. The authors consider it as the main indicator of acoustic trauma. The second symptom was hearing loss. It was commoner in the left ear with a mean loss of 33.98 dB HL at presentation. The main frequencies affected were 4 and 6 KHz. All patients were managed within 24 hours. They were hospitalised and received and IV infusion of methylprednisolone (1.5 mg/kg/day) in the morning and pentoxyfilline 300 mg twice daily. The majority were treated for five days with a maximum of 10 days. In more severe cases and those not responding within 48 hours hyperbaric oxygen therapy was added for two sessions. Audiograms were evaluated on admission, at discharge and one month later. The average audiometric gain was 13.85 dB HL at discharge and 18.28 dB HL on the later evaluation. In 40% of cases hearing loss was permanent especially if the initial loss was 40 dB or more. One of most recognised risk factors is non-compliance with the use of ear protectors. Most responders mentioned malpositions, falls and interference with their field performance by hampering auditory interaction with their environment and balance problems.