Because noise is a general stressor, noise in the OR should be avoided whenever possible. This article presents the results of a review of the research literature on the topic of noise in the OR. A systematic literature search was conducted. Eighteen relevant articles were identified and categorized as follows: noise levels, noise sources, staff performances, and patient's perception of noise. Each study was assessed according to the strength of the evidence and the quality of the study. Noise levels in the OR in general exceed recommended levels, and the noise sources are related to equipment and staff behavior. The main effect of noise on staff performances is related to impaired communication, resulting in a negative effect on patient safety. The literature on patients' perception of noise is both limited and inconsistent, and more research on this topic is needed.