Title: The Relationship between Noise Exposure with Blood Pressure and Pulse of Workers in a Cement Packaging IndustryBackground: Noise pollution is the distrubing or excessive noise that may annoying, distracting or even harmfull to the people who hear it. Noise pollution can induces alteration of various physiological responses, especially on the cardiovascular system, in people exposed to it. The aim of the study was to analyze the relationship between noise exposure with blood pressure and pulse of workers in cement packaging industry. Methods: A cross sectional study design was employed in 2016 at cement packaging industry in Tuban, Indonesia. Sample size were 22 workers obtained by using simple random sampling technique. Noise level was measured at production unit with a calibrated Sound Level Meter. Workers characteristics were gathered with an appropriate questionnaire. Blood pressure and pulse were measured cross shift (before and after noise exposure) using digital tensimeter. For analyzing data, paired t-test and pearson correlation test were used. P < 0.050 was considered statistically significant.Results: Noise level at all production areas were exceed the TLV, over 85 dBA. Most workers were 42 years old, had over 15 years of worked periode and 77.3% of respondents were using EPE with ear plug type. Either sistolic and diastolic blood pressure before noise exposure were normal, but after that, they were prehypertension. Mean pulse of workers before and after noise exposure were 76,64 x/second and 86,91 x/second.Conclusion: There were significant differences between the systolic blood pressure, diastolic and pulse before and after work. Meanwhile, there were significant associations between noise with raised systolic blood pressure, diastolic blood pressure and pulse on workers of cement packaging industry. So, preventive of noise should be controled by using convenient EPE for workers.