Purpose of review Implantable hearing devices have been developed to address the shortcomings of traditional hearing aids. Currently, there are two US Food and Drug Administration clinical trials evaluating fully implantable hearing devices. Recent findings Implantable hearing devices attempt to improve upon stigma, cosmesis, occlusion effect, and feedback, as well as other factors that prevent patients from using traditional hearing aids. However, there are many challenges inherent in designing an implantable hearing device. Different devices have attempted to overcome these challenges in different ways. We will discuss these differences in design, their individual pros and cons as well as directions of future research. Summary Although implantable hearing devices are not currently available they do hold promise for patients not adequately served by conventional hearing aids.