All hydraulic machinery has a tip clearance, which not only produces tip-leakage vortexes (TLVs), but also reduces the energy performance of the machinery. In addition, tip clearance leads to cavitation and attendant vibration and noise. Therefore, investigating tip-leakage cavitating flow and noise characteristics is of great practical importance. In this paper, the energy performance and noise characteristics of NACA0009 hydrofoils with different tip clearance sizes are studied. A large eddy simulation model and Schnerr–Sauer cavitation model are employed to simulate tip-leakage cavitating flow. Additionally, a broadband noise source model and the Ffowcs Williams–Hawkings (FW–H) equation are used to calculate the noise source and far-field radiated noise characteristics, respectively. Results show that the numerical simulation of cavitation vortex and velocity field is in good agreement with the experimental data, illuminating the characteristics of energy performance, flow pattern, cavitation flow, broadband noise source, and near-field and far-field radiated noise. Compared with the original NACA0009 hydrofoil, the tip clearance reduces the noise of the Curle dipole on the hydrofoil surface and Proudman noise around the hydrofoil. Moreover, study of the far-field noise shows that the directivity curve of the overall sound pressure level (SPL) is distributed in a butterfly shape, symmetrically. Evidently, the tip clearance size has a large impact on the energy performance of the hydrofoil, the intensity of the TLV, and the cavitation. This paper lays a solid foundation for further research on cavitation flow in large-scale hydraulic machinery.