@sf_junkie said in Odd Sound Issue with Neo-Geo games when loading a save state:

lr-fbalpha

I don't think anyone is gonna provide that kind of support for several years old version of our project (i certainly won't), so you should use the current version (FBNeo), furthermore that issue is probably something we solved long ago because afaik those games work properly with runahead (which saves and load states at every frame).

Yes, it looks like a bug in the emulator (mame2003) - though it says it saves/loads the state, this is not correct.
What you can do is use lr-fbneo for this game, the ROM is compatible and save states are supported and work.