In the EU it is a requirement to provide information on the potential effects of noise to support the development of new railways. This information includes an assessment of the noise effects on people and the mitigation strategies to avoid or reduce the potential adverse effects. In some communities there may be concern that noise exposure caused by high speed trains has unique characteristics that could result in a greater impact than that which might occur from conventional rail. Environmental noise can cause annoyance and sleep disturbance effects. The likely scale of annoyance and sleep disturbance can be correlated with noise indices. There is growing concern in some circumstances that long term exposure to environmental noise may cause indirect cognitive effects and physical health effects such as myocardial infarction. This paper reviews the evidence on the possible effects of noise from transportation on physical health and social well-being. The influence of parameters such as sound pressure rise time, noise event duration, source to receiver distances and simultaneous exposure to perceptible vibration is reviewed based upon recently published studies. Emphasis is given on the availability of evidence related to railway noise, and high speed railways in particular.