South African Premier Soccer League (PSL) matches are known worldwide as some of the noisiest recreational events. Therefore, the objectives of this study were to i) measure noise levels during different PSL matches; ii) measure changes in auditory function after attending PSL matches; and iii) determine the factors that increase the risk of overexposure to noise during PSL matches. The study used a descriptive quantitative analytical pre- and post-exposure design. Participants (n = 19, and n = 10) attended two PSL matches. Each participant′s auditory function was assessed using distortion product oto-acoustic emissions (DPOAEs) before and after attending a PSL match. Peak and equivalent continuous noise levels as well as noise dose were measured during each match. Noise levels recorded during the poorly attended Match 1 were lesser than those of the well-attended Match 2. Participants attending Match 2 had statistically significant reduction in their DPOAE amplitudes after the match (P = 0.003) than those attending Match 1. Vuvuzela blowers and participants seated within 1 m from them were most at risk of harm to their hearing with significant reduction in DPOAE amplitudes post the match (P = 0.002 and P = 0.008, respectively). It was therefore concluded that noise levels at well-attended South African PSL matches pose a significant risk to spectators′ auditory function as shown by reduced DPOAE amplitude post match attendance. Three risk factors for overexposure to noise during the match were identified: blowing the vuvuzela, close proximity to the individual blowing the vuvuzela as well as spectator turnout at the match.