The unique ability of titanium to osseointegrate has been utilized in clinical practice for bone-anchored hearing aids in Sweden since 1977. The percutaneous design by Nobelpharma has been shown to be useful not only for pure conductive hearing loss but also mixed losses with a bone pure tone average of 45 dB (60 dB with the HC220). We examine our experience, since May 1991, with 15 patients aged 8 to 73 years, including indications, complications, and both objective and subjective results. In addition, we have found the second stage can be successfully completed during the initial anesthetic without the usual delay of 3 months for many patients. We believe the technique for osseointegration is a suitable addition to the armamentarium for the otolaryngologist against hearing loss.