Objective: In 2006 the National Acoustic Laboratories was commissioned to create a telephone-based hearing screening test. Design: NAL developed ‘Telscreen’, a speech-in-noise test modelled on the Dutch and UK telephone tests. The first version, Telscreen I, had several novel features: individual scoring of digits; individual equalization of digit intelligibility; and accuracy-determined test termination. Evaluation of Telscreen I revealed that it did not discriminate satisfactorily between those with and without hearing impairment. Subsequently Telscreen II, which included a novel sensitized masking noise, was developed. Study sample: Telscreen I was evaluated by 105 participants (22–86 years), 37% with normal hearing (all thresholds <20 dB HL in the test ear), 63% with hearing impairment (all thresholds >20 dB HL in the test ear). Telscreen II was evaluated by 75 participants (25–86 years), 33% with normal hearing, 67% with hearing impairment. Results: Correlations between Telscreen I results and hearing thresholds, r = 0.57, and hearing disability scores, r = 0.51 were highly significant, but lower than expected. Correlations for Telscreen II were higher: r = 0.77 and 0.65, respectively. Telscreen II was found to have high sensitivity: 90%; and specificity: 90.2%. Conclusions: Telscreen II is an efficient, reliable, and innovative hearing screening test that provides a solid foundation for future tests delivered via mobile and internet technologies.