The combination of high flow rates, operating pressures and differential pressure that exist in oil & gas and petrochemical facilities can result in very high noise levels internal to the process piping. This often results in high external noise levels that require mitigation in order to meet OSHA permissible limits and/or avoid other problems. However, even more immediate reliability risks can result from high valve noise, including flow-induced turbulence and high shaking forces, flow-induced pulsations and resonant vibration of side branches or insertion elements, and acoustically induced fatigue failures of welded connections in downstream piping. Each of these phenomena manifest themselves differently based on potential failure locations and frequency content of dynamic pressures and vibration measurements. This paper describes each of these phenomena in detail, including a description of relevant physics, past and current analysis approaches, troubleshooting symptoms, and potential mitigations.