Children with unilateral hearing loss have been considered to have few, if any, communication or academic difficulties. This study was designed to evaluate the academic achievement, cognitive ability, psycholinguistic, and social skills of a group of 25 monaurally hearing-impaired compared with 25 nonhearing-impaired children. Results indicated no significant differences between the two groups on cognitive or self-concept measures. However, the unilateral group had significantly lower scores on academic tests of word recognition, spelling, and language. The unilateral group was more likely to have repeated a grade, needed special education resource help, or additional tutoring in school. Within the unilateral group, children with severe-to-profound hearing loss had significantly lower WISC-R full scale I.Q.s as compared to the group with mild-to-moderate hearing loss. The results of this study suggest that monaural deafness, especially when severe to profound, may be associated with cognitive and academic deficits, as well as secondary behavioral adjustment problems.