Background: Previous studies indicate that hearing loss have negative emotional implications also on spouses of the hearing impaired persons. We sought to assess the relationship between hearing impairment and spousal mental health in the general population. Methods: Pure tone audiometry and questionnaires were administered to the adult population of Nord–Trøndelag County, Norway (1996–97). In the age group between 20 and 44 years, the number of cases with hearing impairment was very low; thus, this age group was excluded from analyses. In total, 8607 couples with women over 44 years and 9530 couples with men over 44 years were identified. Associations between measured and self-reported hearing impairment and spousal self-reported symptoms of anxiety and depression, and subjective well-being were estimated. Stratified by sex and adjusting for several covariates, mental health in spouses of persons with hearing impairment was compared with that of spouses of persons with normal hearing using the general linear model. Results: Audiometrically measured hearing was not significantly associated with spousal mental health. Moderate relations between self-reported hearing and spousal mental health were observed. Conclusion: Contrary to previous results based on self-reported hearing loss, our results based on audiometry did not indicate severe loss of mental health among spouses of persons with impaired hearing.