The bone anchored hearing aid (B.A.H.A.) has been fitted to 10 of our patients presenting a bilateral profound conductive hearing loss and who were unable to wear a classical hearing aid. The group of patients with bilateral inoperable aural atresia (n = 5) formed the main indication and were found to give the best results. Cases with bilateral chronic otitis media (n = 5), presenting otorrhea each time a classical hearing aid was worn, formed the second indication. Audiometric performances are dependent on the bone conduction thresholds. The auricular epithesis has been adapted in 11 cases, mainly for atretic ears. The surgery for B.A.H.A. and epithesis is now routinely performed in one stage and has been found safe and reliable. The skin reactions around the abutments (total number fixtures = 32) were found to be rare and often easy to treat. Only around one abutment further subcutaneous tissue reduction was necessary to stabilize the skin. The B.A.H.A. and auricular epithesis are valuable alternatives in those cases where the limits of reconstructive (middle or outer ear) surgery are reached.