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To determine the incidence of complications associated with implantation of the bone-anchored hearing aid (BAHA) and the management of these complications.Retrospective case review.Tertiary referral center.One hundred forty-nine consecutive patients between October 25, 2001, and June 29, 2005, underwent implantation of a BAHA. The majority of patients had unilateral profound sensorineural hearing loss after removal of an acoustic neuroma or skull base tumor (59.1%) with the next most common etiology of deafness secondary to sudden sensorineural hearing loss (16.1%).Implantation of a BAHA.Incidence of complications occurring after implantation of a BAHA.There were no intraoperative or perioperative complications. Significant postoperative complications requiring intervention occurred in 19 (12.8%) patients. Skin overgrowing the abutment occurred in 11 (7.4%) patients, and 10 of these patients required revision in the operating room. Skin overgrowth was a late complication, occurring an average of 12 months after the initial procedure. Implant extrusion occurred in 5 (3.4%) patients, with 3 requiring revision surgery. Two patients elected not to have the device reimplanted. Two patients had local wound infections requiring oral antibiotics.Significant complications are uncommon after implantation of a BAHA; however, these complications may require local wound care, antibiotics, or revision surgery.