ObjectiveData from the National Health and Nutrition Examination Survey (NHANES) were used to assess the association between the triglyceride-glucose (TyG) index and hearing impairment (HI).MethodsWe used eight survey cycles from NHANES 2001–2012 and 2015–2018 to conduct this cross-sectional study. HI was designed as an dependent variable, and the TyG index was selected as an exposure factor (independent variable). The correlation between the two variables was assessed using multiple logistic regression. In order to assess whether there was a non-linear relationship between the TyG index and HI, the TyG index was distributed and a test for trend was conducted (P for trend), followed by smooth curve fitting (penalized spline) and generalized additive model (GAM) regression. We also performed a subgroup analysis to identify sensitive groups whose responses were clearly associated with independent variables.Results10,906 participants were finally included in the study, and those with a higher TyG index had a higher frequency of hearing impairment. There was a linear positive correlation between the TyG index and HI. For the low-frequency HI, however, this positive correlation was not statistically significant (OR = 1.05, 95% CI: 0.98, 1.14); however, it was more stable for the high-frequency HI (OR = 1.12, 95% CI: 1.03, 1.22). Additionally, as the TyG index increased, this positive association increased as well (P for trend = 0.05). The HPTA test showed a positive association with more severe HI (simultaneous) as the independent variable increased (OR = 1.14, 95% CI: 1.05–1.24), and this association was even more significant with increasing severity (P for trend 0.05). According to the subgroup analysis, the positive association between TyG index and high-frequency HI was more significant in females, 40–69 years old, without hypertension or diabetes, and when strict high-frequency HI was significant in males, females, 40–69 years old, with hypertension and diabetes.ConclusionParticipants with a higher TyG index may have a higher risk of HI. TyG index and HI risk showed a linear relationship, which became even more significant when HPTA was included.