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Objective: This study aims to explore the association between coffee consumption and the prevalence of hearing loss in American adults based on a national population-based survey. Design: Cross-sectional analysis of reported audiometric status and coffee intake from the 2003–2006 National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression, forest plots and restricted cubic spline (RCS) analyses were used to explore the associations and dose–response relationships between coffee consumption frequency and hearing loss. Setting: The USA. Participant: This study included 1894 individuals aged ≥ 20 from the 2003–2006 NHANES. Results: In this study, the prevalence of speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) among the participants was 35·90 % and 51·54 %, respectively. Compared with those who no consumed coffee, non-Hispanic White who consumed ≥ 4 cups/d had higher prevalence of SFHL (OR: 1·87; 95 % CI: 1·003. 3·47). And a positive trend of coffee consumption frequency with the prevalence of HFHL was found (P trend = 0·001). This association of HFHL was similar for participants aged 20–64 (P trend = 0·001), non-Hispanic White (P trend = 0·002), non-noise exposure participants (P trend = 0·03) and noise-exposed participants (P trend = 0·003). The forest plots analysis found that the association between 1 cup-increment of daily coffee consumption and the prevalence of HFHL was statistically significant in males. RCS model supported a positive linear association of coffee consumption with SFHL (P for overall association = 0·02, P for nonlinearity = 0·48) and a positive non-linear association of coffee consumption with HFHL (P for overall association = 0·001, P for nonlinearity = 0·001). Conclusion: Our findings suggested that coffee consumption was associated with higher prevalence of hearing loss. Further cohort studies in larger population are needed to investigate these findings. [ABSTRACT FROM AUTHOR]