Objective To compare the speech frequency and extended high-frequency hearing thresholds between regular employees and those exposed to occupational noise using extended high-frequency audiometry (EHFA), and to evaluate the clinical value of EHFA in the early diagnosis of hearing impairment among occupational noise-exposed populations. Methods A total of 119 employees (95 males and 24 females; aged 23 to 67 years) who underwent occupational health examinations at the Second Hospital of Lanzhou University in 2023 were enrolled in the study and classified according to their noise exposure working years. All participants underwent routine otologic examinations, tympanometry, conventional pure-tone audiometry from 0.125 to 8 kHz, and EHFA from 9 to 16 kHz. Data analysis was performed using SPSS 29.0.1.0 software. Results The extended high-frequency thresholds (9-16 kHz) demonstrated a significant correlation with the duration of sustained occupational noise exposure. After removing the influence of age, the extended high-frequency thresholds in the left ear at 11.2 kHz, the right ear at 9,10,11.2, and 12.5 kHz still had a significant correlation with the duration of continuous noise exposure. Conclusion EHFA is an effective method for assessing hearing loss in the high and ultra-high frequency ranges. It can monitor possible early hearing loss in noise-exposed populations and has significant clinical significance for the early detection of occupational diseases such as noise-induced hearing loss.