Subjective annoyance is the best-studied, and in terms of disability adjusted life years (DALYs), the most relevant effect of long-term transportation noise exposure. However, relatively few studies have addressed whether and how noise annoyance translates into long-term health effects. On the one hand, it has been hypothesized that high annoyance is amplifying physiological stress reactions and thus more pronounced health effects from noise exposure would be expected. On the other hand, physiological reactions have been observed to be independent of the subjective noise rating, and it has thus been hypothesized that noise annoyance and somatic health effects are two distinct biological pathways. To date, a growing body of epidemiological research included noise annoyance and noise sensitivity as effect modifier in the analysis of transportation noise exposure and various somatic diseases such as myocardial infarction or diabetes. In this presentation, an overview about the epidemiological research on this topic is given. From there, it will be evaluated whether, and if so to what extent, reduction in subjective noise annoyance is also expected to be beneficial for other noise induced health effects.