ICAO Balanced Approach (BA) to aircraft noise management in airports is reviewed in accordance with historical and technological challenges. All four basic elements of the BA are subject to noise exposure control with dominant emphasis on reduction of noise at source and compatible land usage inside the noise zoning around the airports. Noise abatement procedures and flight restrictions are used at any airport due to its specific issues and should be implemented on a basis of cost–benefit analysis. Noise exposure reduction is an intermediate goal, a final goal—to reduce noise impact, which is mostly represented by population annoyance as a reaction to noise exposure, is discussed also.