Aiming at the engineering limitations of traditional ship vibration online monitoring and noise prediction methods, this paper proposes a method for online monitoring and underwater radiation noise prediction of cabin structures’ vibration and noise under hybrid excitation of sound and force. The method first constructs the condition test model; based on OTPA technology, the “acoustic-vibration” transfer function between sound and vibration monitoring points in the cabin and the “acoustic/vibration-acoustic” transmission network inside and outside the cabin structure are obtained. Secondly, based on the “acoustic-vibration” transfer function, the online vibration and sound monitoring data are decoupled and processed to obtain the modified vibration and sound monitoring data. Finally, the near-field radiation noise on the conformal hologram surface outside the cabin is predicted based on the “acoustic/vibration-acoustic” transmission network, and the far-field radiation noise of the cabin structure is predicted by the wave superposition method. In this paper, the contribution law of external radiation noise and the coupling characteristics of the monitoring information under the hybrid excitation of sound and force are analyzed theoretically, and the decoupling method of coupling information is also studied. This method makes up for the problem of missing underwater radiation noise caused by sound excitation in traditional vibration monitoring, and it can effectively improve the prediction accuracy of underwater radiation noise. The effectiveness of the method is further verified by the tank model experiments.