Abstract: Elevated noise exposure is prevalent in the NICU and may compromise preterm infants' physiological stability, sleep, and neurodevelopment. Therefore, the acoustic environment is a key monitorable and modifiable component of developmental supportive care. This review synthesizes current evidence regarding the potential mechanisms by which the NICU acoustic environment affects auditory neurodevelopment, identifies common noise sources and management challenges, and discusses emerging strategies, including intelligent acoustic monitoring, alarm management, active noise reduction, standardized nursing practice, and individualized auditory support. It aims to provide a reference for intelligent management of the NICU acoustic environment and auditory neuroprotection in preterm infants.

Key words: Neonatal Intensive Care Unit; preterm infant; acoustic environment; auditory neuroprotection; intelligent management