Hearing loss is one of the most common long-term health conditions associated with ageing, and a considerable contributor to Australia’s late-life disability burden. Acquired hearing loss in adulthood presents significant challenges for the social, physical, mental and cognitive health of many Australians. These wide-ranging individual and societal impacts have been highlighted by a number of high-profile national inquiries into Australia’s hearing health during the past decade. Yet hearing loss remains poorly recognised and is under-treated in many communities. In this perspective article, the authors argue that effective public health measures, such as limiting occupational and recreational exposure to hazardous noise and ototoxic chemicals, promoting hearing health behaviours, early detection, improved access to hearing health services, and urban design, are all critical to mitigating these adverse outcomes. They also make the case for updated epidemiological data about hearing loss among older Australians.