Today, the growth of the aging population in Europe needs an increasing number of health care professionals and facilities for aged persons. Medical telemonitoring at home (and, more generally, telemedicine) improves the patient's comfort and reduces hospitalization costs. Using sound surveillance as an alternative solution to video telemonitoring, this paper deals with the detection and classification of alarming sounds in a noisy environment. The proposed sound analysis system can detect distress or everyday sounds everywhere in the monitored apartment, and is connected to classical medical telemonitoring sensors through a data fusion process. The sound analysis system is divided in two stages: sound detection and classification. The first analysis stage (sound detection) must extract significant sounds from a continuous signal flow. A new detection algorithm based on discrete wavelet transform is proposed in this paper, which leads to accurate results when applied to nonstationary signals (such as impulsive sounds). The algorithm presented in this paper was evaluated in a noisy environment and is favorably compared to the state of the art algorithms in the field. The second stage of the system is sound classification, which uses a statistical approach to identify unknown sounds. A statistical study was done to find out the most discriminant acoustical parameters in the input of the classification module. New wavelet based parameters, better adapted to noise, are proposed in this paper. The telemonitoring system validation is presented through various real and simulated test sets. The global sound based system leads to a 3% missed alarm rate and could be fused with other medical sensors to improve performance.