Annual spawning aggregations of red hind Epinephelus guttatus form at predictable times and locations and have historically succumbed to overfishing. Monitoring the status and restoration of aggregations is essential for evaluating the effectiveness of fishery management measures. Passive acoustic and diver-based underwater visual census (UVC) techniques were used to develop an efficient method for estimating red hind density from sound production at spawning aggregations. Red hind sound production was recorded from November 2010 to April 2011 at Abrir la Sierra, Puerto Rico. UVC surveys were conducted during the spawning season to assess changes in red hind density over a fixed time and area. Sound recorded from 18:00 to 19:00 h Atlantic Standard Time (UTC − 4) was representative of total daily changes in red hind sound production and was selected for the development of an efficient density estimation model. Pronounced daily changes in sound production and density were observed after the December 2010 and January 2011 full moons. Two hourly sound level measurements were compared to densities estimated by UVC surveys, yielding significant linear regressions, which were used to predict changes in fish density as measured at the aggregation site. Passive acoustic methods allowed to predict changes in red hind density and habitat use at a higher temporal resolution than previously possible with traditional methods. Red hind sound production and inferred densities can be monitored and analyzed efficiently for multiple aggregation sites simultaneously, documenting short-term and long-term changes in red hind densities at spawning aggregation sites and providing important information for the support or development of management strategies.