Abstract Background The rapid, unregulated expansion of the call center industry in developing countries has increased occupational health risks for young adults, particularly with regard to auditory health. Prolonged exposure to acoustic trauma, long working hours, and the high intensity nature of call center work can negatively affect young adults at the start of their working lives and may contribute to permanent noise induced hearing loss (NIHL). This damage is often irreversible but preventable if identified at an early stage. This study aims to evaluate the burden of auditory impairment among call center employees in Egypt and to propose evidence based mitigation strategies. Methods A pilot cross sectional study was conducted among employees of various medical call centers over approximately three months (January to March 2026). Participants were recruited through voluntary (self selected) sampling. Data were collected using a structured questionnaire on work history, and statistical analysis was performed to examine associations with work duration and intensity. Three semi structured, open ended interviews were conducted in March 2026 to explore the symptoms in greater depth. Results Forty six call center employees completed the questionnaire. The most frequently reported symptoms were mishearing words (82.6%), difficulty understanding speech in background noise (80.4%), needing others to repeat themselves (78.3%), and sensitivity to loud sounds (78.3%); 60.9% reported tinnitus. Higher auditory symptom severity was associated with a history of acoustic shock (Mann Whitney U = 344.0, p = .004) and with greater cognitive symptom burden (Spearman's {rho} = .416, p = .004), but not significantly with shift type (p = .177), years of work (p = .885), or daily and weekly working hours. Qualitative interviews described auditory strain that builds through the shift, disrupted sleep, informal coping, and the absence of employer guidance or symptom reporting pathways. Conclusion and Recommendations Self reported auditory symptoms were common in this preliminary sample of call center employees and were associated with acoustic shock exposure and cognitive symptom burden, but not significantly with shift pattern or length of service. Because the study was cross sectional, relied on self reports, and used a small volunteer sample (pilot study), the findings cannot establish causation or true prevalence. Recommended measures include acoustic shock limiters with incident reporting, audiometric screening that prioritizes at risk employees, safe volume education with regular breaks, and educational programs on auditory hazards and early warning signs to prevent actual auditory damage. Larger multi site studies with audiometric confirmation are also needed. Keywords: noise induced hearing loss; call center employees; occupational health; auditory dysfunction; tinnitus; acoustic shock; shift work; Egypt