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Background: Noise phobia is a common behavior problem in dogs for which there are limited treatment options. Objective: To evaluate the efficacy and safety of imepitoin in comparison to placebo for the control of anxiety and fear associated with noise phobia in dogs. Animals: Two hundred thirty‐eight client‐owned dogs with noise phobia were recruited in veterinary clinics. Methods: This placebo‐controlled, randomized, double‐blinded, clinical trial used a predictable noise event as eliciting context, the traditional New Year's Eve fireworks in Germany and the Netherlands. Owners began treatment 2 days before the anticipated noise event with administration of either imepitoin 30 mg/kg body weight Q12h or placebo for 3 consecutive days. On New Year's Eve, owners noted their observations of their dog's fear and anxiety behavior at 1600, 2200, 0020, and 0100 hours and scored the overall treatment effect on the following day. Results: In the 16‐item owner report of fear and anxiety signs, fear and anxiety behaviors were significantly reduced under imepitoin treatment compared to placebo (delta −6.1 scoring points; P < .0001). A significantly higher proportion of owners reported a good or excellent overall treatment effect in the imepitoin group compared to placebo (odds ratio 4.689; 95% CI, 2.79‐7.89; P < .0001). Conclusion: Imepitoin effectively controls fear and anxiety associated with noise phobia in dogs. [ABSTRACT FROM AUTHOR]