Patients with a mixed hearing loss present special challenges. The amplification demands of mixed hearing loss can drive powerful digital hearing aids to their limits and introduce distortion through saturation. Conversely, the Baha® System effectively bypasses the conductive component and focuses on compensating for the sensorineural component of the hearing loss. Ten patients with a mixed hearing loss participated in the present study. Results indicate that Baha provided significant benefits (p < 0.01) over conventional air conduction hearing instruments across the dimensions of audibility, speech understanding and sound quality. Given the increased output force of the latest Baha instruments, once the conductive component of a severe mixed hearing loss becomes greater than 30 dB, a Baha should be considered and evaluated on audiological grounds alone to provide optimal amplification. Copyright © 2009 John Wiley & Sons, Ltd.