Hearing damage is the number one service-connected disability among post-9/11 war Veterans. Historically, noise over-exposure has been the primary cause of hearing damage and resulting disability. Recent anecdotal reports from audiology clinics have noticed an increase in Veterans with post-traumatic stress disorder (PTSD) seeking hearing treatment for problems communicating in noisy environments and on the telephone. Therefore, we examined hearing difficulty in complex listening environments in post-9/11 Veterans in relation to PTSD. Participants in the longitudinal Noise Outcomes in Servicemembers Epidemiology Study completed baseline questionnaires to assess demographic and military service characteristics, PTSD symptoms, and auditory function. Based on an a priori causal model, multivariable regression models were adjusted for key demographic and military service characteristics. Of 304 enrolled Veterans, 127 (42%) screened positive for PTSD. All Veterans had essentially normal hearing ability. Despite this, Veterans with PTSD scored significantly poorer on behavioral tests of complex listening where speech presented simultaneously to both ears must be integrated, as well as on tests separating speech from noise. Veterans with PTSD, compared to those without PTSD, reported poorer hearing in complex listening environments and were 5.4 times (95% CI: 3.1 – 9.6) more likely to report hearing handicap. We identified greater hearing difficulty in complex listening situations both behaviorally and subjectively among Veterans with, versus without, PTSD while controlling for potential confounders. This difficulty may cause Veterans to face adversity, challenging their ability to reintegrate into civilian life and compounding adverse effects of other service-related disabilities.