BackgroundNeonates with immature auditory function (eg, weak/absent middle ear muscle reflex) could conceivably be vulnerable to noise‐induced hearing loss; however, it is unclear if neonates show evidence of hearing loss following MRI acoustic noise exposure.PurposeTo explore the auditory effects of MRI acoustic noise in neonates.Study TypeProspective.SubjectsTwo independent cohorts of neonates (N = 19 and N = 18; mean gestational‐age, 38.75 ± 2.18 and 39.01 ± 1.83 weeks).Field Strength/SequenceT1‐weighted three‐dimensional gradient‐echo sequence, T2‐weighted fast spin‐echo sequence, single‐shot echo‐planar imaging‐based diffusion‐tensor imaging, single‐shot echo‐planar imaging‐based diffusion‐kurtosis imaging and T2‐weighted fluid‐attenuated inversion recovery sequence at 3.0 T.AssessmentAll neonates wore ear protection during scan protocols lasted ~40 minutes. Equivalent sound pressure levels (SPLs) were measured for both cohorts. In cohort1, left‐ and right‐ear auditory brainstem response (ABR) was measured before (baseline) and after (follow‐up) MRI, included assessment of ABR threshold, wave I, III and V latencies and interpeak interval to determine the functional status of auditory nerve and brainstem. In cohort2, baseline and follow‐up left‐ and right‐ear distortion product otoacoustic emission (DPOAE) amplitudes were assessed at 1.2 to 7.0 kHz to determine cochlear function.Statistical TestWilcoxon signed‐rank or paired t‐tests with Bonferroni's correction were used to compare the differences between baseline and follow‐up ABR and DPOAE measures.ResultsEquivalent SPLs ranged from 103.5 to 113.6 dBA. No significant differences between baseline and follow‐up were detected in left‐ or right‐ear ABR measures (P > 0.999, Bonferroni corrected) in cohort1, or in DPOAE levels at 1.2 to 7.0 kHz in cohort2 (all P > 0.999 Bonferroni corrected except for left‐ear levels at 3.5 and 7.0 kHz with corrected P = 0.138 and P = 0.533).Data ConclusionA single 40‐minute 3‐T MRI with equivalent SPLs of 103.5–113.6 dBA did not result in significant transient disruption of auditory function, as measured by ABR and DPOAE, in neonates with adequate hearing protection.Evidence Level2.Technical EfficacyStage 5.