Background: Genetic factors and gene-environment interaction may play an important role in the development of noise induced hearing loss (NIHL). This study explored the relationship between the SNP of CASP genes and the NIHL susceptibility of Chinese workers exposed to occupational noise.Methods: 191 cases and 191 controls were selected by 1:1 case control study. Among them, case groups were screened from workers exposed to noise at binaural high-frequency hearing thresholds greater than 25 dB (A). The control group selected workers with hearing thresholds≤25 dB (A) in any binaural frequency band based on matching factors such as age, exposure time to noise, and operating position. The blood samples of two groups of workers were subjected to DNA extraction and SNP sequencing of CASP3 and CASP7 genes using the polymerase chain reaction - ligase detection reaction method. Conditional logistic regression correction was used to analyze genetic variation associated with susceptibility to NIHL. Odds Ratios (OR) and 95% confidence intervals (CI) were calculated.Results: There was an association between rs2227310 and rs4353229 of the CASP7 gene and the risk of NIHL. Compared with the GG genotype, the CC genotype of rs2227310 reduced the risk of NIHL (OR = 0.453, 95% CI = 0.241 ~ 0.852). Compared with CC genotype, the TT genotype of rs4353229 reduced the risk of NIHL (OR = 0.458, 95% CI = 0.243 ~ 0.862). Workers carrying the rs2227310GG and rs4353229CC genotype had an increased risk of NIHL compared to workers without any high-risk genotype (OR = 1.839, 95% CI = 1.033 ~ 3.274). The CASP7 gene interacted with factors such as age, smoking status, dietary taste, and conscious auditory system symptoms on the risk of NIHL (P <0.05).Conclusions: The single nucleotide polymorphism of CASP7 gene interacts with factors such as age, frequency of smoking, dietary taste, and conscious auditory system symptoms on the risk of NIHL.