Anthropogenic noise in most parts of the Earth’s oceans is increasing. If not managed appropriately, it has the potential to significantly impact marine mammals and their ability to interact with their environment. Marine mammals rely heavily on sound for critical life functions, and anthropogenic noise can interfere with sound sensing and usage, through masking, behavioral disturbance, stress, noise-induced temporary hearing loss, and, in extreme cases, injury to tissues and organs. Depending on the severity and context of a noise exposure, noise-induced impacts to individual animals could translate to population-level impacts. This chapter highlights the importance of managing anthropogenic noise, identifying limitations in existing management approaches, and briefly covering management approaches from different jurisdictions. Significant gaps in our understanding of species responsiveness to anthropogenic noise, the status of existing marine mammal populations, and characterization of underwater noise sources present challenges for the robust prediction and management of underwater noise. Based on current knowledge, a best-practice approach to the management of anthropogenic noise is presented whereby management might best achieve desired environmental outcomes. A focus on desired environmental outcomes provides a framework for robust, adaptable, and context-dependent management of underwater noise that more effectively supports species conservation.