As intensive aquaculture continues to develop, substantial investments have been made in equipment to sustain high-density farming. However, this has resulted in elevated noise levels within these aquaculture environments, particularly below 2000 Hz, matching the hearing range of most cultured fish species. Fish under noise conditions may experience hearing loss and physiological stress, which can negatively affect their growth, foraging efficiency, reproductive success, and increase their susceptibility to diseases. These adverse effects compromise the welfare of cultured fish, potentially decreasing production quality and increasing mortality rates. Despite these notable effects, the understanding and management of noise conditions in aquaculture systems lag behind other environmental parameters in terms of recognition and control. In this review, we cover the fundamentals of fish auditory systems, the hearing range of key cultured fish species, and the most common noise sources and levels prevalent in current intensive aquaculture systems. Additionally, we examine recent discoveries on the effects of anthropogenic noise on fish hearing, physiological responses, and behavior. Finally, we provide strategies for noise monitoring and management in the aquaculture industry, while also highlighting open questions for future research. Our goal is to assist researchers and practitioners in comprehending underwater noise and its effects on cultured fish species, providing a valuable resource for promoting the healthy and sustainable development of intensive aquaculture.