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The purpose of the study was to examine the existence of an association between child blood pressure (BP) and exposure to domestic jet aircraft noise in the context of the construction of a new parallel north-south runway at Sydney (Kingsford-Smith) Airport. The baseline study was commissioned and funded by the Federal Airports Corporation (FAC), with measurements conducted in 1994 and 1995. A follow-up longitudinal component to the study was subsequently commissioned and funded by the FAC in 1997, and measurements conducted in the same year. As the same individuals were measured and re-measured over changing conditions of exposure to aircraft noise, the quasiexperimental nature of the study allowed inferences to be made regarding exposure to aircraft noise and child BP. The main hypotheses for testing were that BP, and within-subject longitudinal changes in BP, are positively related to domestic jet aircraft noise exposure and longitudinal changes in domestic jet aircraft noise exposure respectively. Subsidiary hypotheses tested for evidence of short- and long-term BP adaptation effects where BPs were related to prior changes to aircraft noise exposures. A sample of 75 primary schools within a 20 km radius of Sydney Airport under various noise exposure conditions, both existing and those projected with the advent of the new runway, participated in the study. The baseline cohort comprised 1,230 Year 3/4 children attending the schools in 1994 and 1995, and the follow-up participants comprised 628 of the original baseline sample re-measured in 1997. Study participants were enrolled by active parental consent. The baseline response rate was approximately 40% of children in the participating schools. Systolic (SBP) and diastolic (DBP) blood pressure readings of the children were taken using automated BP measuring equipment along with anthropometric measurements (heights, weights, skinfold thicknesses and waist measurements). Parental surveys captured items pertaining to the child�s ethnic background as measured by the country of birth of the child and parent(s), residential address and housing structure, child eating habits and activity levels, along with family and child history of high blood pressure. Aircraft noise exposure data were collected by the National Acoustic Laboratories and processed into the energy-averaged noise metric used in Australia for aircraft noise exposure assessment called the Australian Noise Exposure Index (ANEI). Mean exposures for a given calendar month were used in the analysis. ANEI values were geocoded to exact geographic locations using digitised street maps from which values for each house and school address, also geocoded, were interpolated. A child BP measured in a given month was matched to a aircraft noise exposure value both at their school and residential address for that month for analysis. After adjusting for confounding and other factors, the cross-sectional relationship between BP and aircraft noise exposure was found to be inconsistent. SBP was nonsignificantly negatively associated with school aircraft noise exposure at baseline (0.05 mmHg/ANEI, cluster-sampling-adjusted p&gt0.05), but positively and non-significantly associated with school aircraft noise exposure at follow-up (0.05 mmHg/ANEI, p&gt0.05). As for SBP, baseline DBP was significantly negatively related to school aircraft noise exposure at (0.09 mmHg/ANEI, p&lt0.001) and non-significantly positively associated with school aircraft noise exposure at follow-up (0.05 mmHg/ANEI, p&gt0.05). Within-subject BP changes, occurring from baseline to follow-up, regressed on corresponding longitudinal changes in aircraft noise exposures produced inconsistent results. SBP change was positively and non-significantly (0.027 mmHg/ANEI, p&gt0.05) associated with corresponding school aircraft noise exposure change, while SBP change was negatively associated total aircraft noise exposure change (statistically nonsignificant, 0.06 mmHg/ANEI, p&gt0.05). DBP changes were similarly and nonsignificantly related to corresponding aircraft noise exposure changes. Some evidence for short-term BP adaptation to recent changes in aircraft noise exposure was found. Consistent negative associations between systolic and diastolic BP and recent changes in school aircraft noise exposure were found. This association was statistically significant at study baseline (SBP: 0.19 mmHg/ANEI, p&lt0.001; DBP: 0.12 mmHg/ANEI, p&lt0.001), and of similar magnitude although not statistically significant at follow-up (SBP: 0.14 mmHg/ANEI; DBP: 0.10 mmHg/ANEI, p&gt0.05). In the presence of inconsistent cross-sectional BP-aircraft noise exposure associations, this finding is consistent with evidence of a homoeostatic BP response to recent changes in aircraft noise exposure, where resting BP returns to pre-existing levels unrelated to aircraft noise exposure. The public health implication of this finding appears to be benign.