To improve conventional bone conduction hearing aids, Tjellstrom, Branemark, developed an implant system consisting of a maxillofacial implant that derived from dental implants and a bone conduction hearing aid that was attached directly to the implant. This system has been commercially available as a bone anchored hearing aid (BAHA). More than 10,000 patients have benefited from BAHA in Scandinavia, North America, and many other regions. BAHA first became available in 1977 in Sweden but has not been used in Japan as widely as expected. This paper reports a case of a 8-year use of BAHA for hearing loss caused by microtia and external auditory canal atresia, with a review of literature. The patient has been followed up for 9 years after implant placement. Play audiometry with a loudspeaker showed a hearing loss of 25 dB. The patient says that BAHA is superior to conventional transcutaneous bone conduction hearing aids in easiness of attachment, esthetics, and speech recognition and music recognition. The skin and the bone around the implants remain in favorable condition. She has been free from the use of a headband for a conventional hearing aid.