The management of hearing loss has suffered an impressive evolution in the last three decades. Whereas in 1980 the only available options for the hearing impaired patient were conventional analogic hearing aids or surgical management of otosclerosis and chronic ear diseases, thirty years later we have a wide range of different options. These include semi-implantable hearing aids, osseointegrated hearing aids, middle ear implants, cochlear implants, and auditory brainstem implants. The evolution in this field seems to be limited only by technological factors. This presentation deals with the indications, basic surgical technique, and results of some of the aforementioned options, emphasizing the evolution of the management of hearing loss over the last years. It is based on the personal experience of the author and will be illustrated with clinical cases to emphasize the usefulness of every option.