It has been said that a shorter tube will provide for a better acoustic response. Consider this. As tubing length increases, resonant frequency decreases and lower frequency sounds increase. Heart sounds normally are considered to have a lower frequency. So what’s the verdict? According to 3M, who did testing on there Littmann series, found that “there is only a small difference in sound between a short tube and long tube stethoscopes”. It is so small that the human ear can’t tell the difference. A longer tube may actually pickup low frequency sounds better. Longer tubing will also give the individual more freedom when working with patients and may relieve back pain. So its a toss up. The manufacturer and style of your stethoscope will ultimately determine the quality of sound regardless of tube length.