BACKGROUND The aim of this study was to assess the ability of hearing aids to reduce the handicap associated with hearing impairment in adults. METHODS Fifty adults aged over 60 who were supplied with an NHS hearing aid had their hearing handicap and communication function recorded at initial hearing aid assessment, and after three months of aid use. Hearing communication function was assessed by a key informant. RESULTS Hearing aid use was associated with considerable score improvements for social and emotional function [20.5, 95 per cent confidence interval (Cl) 15.4-25.6] and communication function (22.9, 95 percent Cl 14.6-31.2). Younger people recorded the greatest reduction in handicap. Overall satisfaction with hearing aid performance was high. CONCLUSIONS Hearing aids are effective in reducing hearing handicap in adults. They represent a good buy for purchasers seeking to achieve health gain for adults with hearing impairment.