Bone anchored hearing aids (BAHA) achieve optimal acoustic coupling by means of direct bone conduction via an osseointegrated percutaneous titanium implant. Currently this system has a record of over 30 years of clinical application and reliability. Patients with bilateral hearing loss with air-bone gaps will benefit from bilateral BAHA fitting. Likewise, unilateral conductive hearing loss with normal hearing on the other side can be treated with a BAHA. New developments in this field include the BAHA Intenso and also novel implant systems, such as the Epiplating system by Medicon, the alpha system by Otomag and the OBC system by Otorix. Due to the advantages of the BAHA system (possibility of preoperative testing, simple surgery without the risk of inner ear damage, MRI compatibility, etc.), the BAHA will keep its important role in hearing rehabilitation even in the era of other partially and totally implantable hearing devices.