Firefighters reside in inherently noisy environments with sirens and emergency alarms. This noise can negatively affect the performance of firefighters and further pose a safety risk. This study investigates the relationship between siren noise exposure and its mental health disorders. In doing so, the study focuses on cognitive function among firefighters, using a Bayesian network model for the first time. This case-control study involved 92 firefighters and was conducted in 2023. Participants were categorized into case and control groups based on their exposure levels to siren noise. Noise exposures were initially measured according to ISO 9612 standards. The questionnaires covered demographic information, scales of their depression, anxiety, and stress, the Buss-Perry aggression questionnaire, and the cognitive failure questionnaire. GeNIe academic software version 2.3 was employed for Bayesian network analysis. The study results indicated a strong association that heightened siren noise exposure with a 100% probability increases depression (10%), stress (14%), anxiety (13%), and aggression (16%). In addition, each variable–noise exposure, depression, stress, anxiety, and aggression was linked to cognitive failure by 8%, 28%, 8%, and 13%, respectively. The combination of variables including noise exposure, depression, anxiety, and other mental health disorders had a 57% increase in cognitive failure. The most influence values were observed between depression and cognitive failures (0.564). The results of this study demonstrated the effect of siren noise exposure and its mental health disorders on cognitive function among firefighters. The results further highlight proper implementation of measures to mitigate these effects, and further required investigation on their effectiveness.