Noise exposure of firefighters results in increased risk of hearing loss. Noise-induced hearing loss (NIHL) can be prevented by the consistent use of hearing protection devices (HPDs). However, little is known about firefighters' perceptions and attitudes on NIHL and HPD use. The purposes of the study were (1) to identify common noise sources of fire fighting equipment and activities; and (2) to describe the attitudes and beliefs of firefighters concerning the importance of their hearing, occupational noise exposure, NIHL, and HPD use. A nonexperimental, descriptive focus group design was used to gather qualitative data from firefighters at two fire houses in southeast Michigan. The study identified sources of noise unique to fire fighting, such as driving fire/emergency trucks with sirens on; operating water pumps, saws, and other equipment; and shouting to communicate with civilians and fellow firefighters. Firefighters acknowledged the significance of good hearing in fire fighting service but perceived NIHL was unavoidable on the job and viewed it as a small risk compared with other hazards. HPDs were not used regularly because firefighters believed they interfered with the ability to hear commands during emergency conditions, interfered with other required safety equipment, and were generally forgotten when gearing up. Firefighters recognized the importance of hearing health and the benefit of a hearing conservation program, including annual training, and identified several topics that should be included in a training program. These findings will provide critical information in planning what type of program should be developed and carried out for the fire fighting population.