Hearing loss is the third most significant cause of disability globally and is associated with anxiety, depression, loneliness, and cognitive decline. For those unable to utilize conventional hearing aids due to conditions such as ear canal atresia, eczema, recurrent external otitis or extensive ear surgery, implantable hearing aids provide an alternative. This narrative review provides an overview of available bone conduction devices and active middle ear implants. The rapid advancements in implantable hearing aid technology necessitate ongoing education of healthcare professionals to enable informed patient decisions.