A year ago, the Food and Drug Administration (FDA) announced new regulations permitting the sale of over-the-counter (OTC) hearing aids and establishing standards for their safety and effectiveness. The goal was to create accessible and affordable options for individuals with mild to moderate hearing loss. However, the OTC market is still confusing and chaotic for older consumers who were meant to benefit from these regulations. Despite this, there has been a growing emphasis on the importance of treating hearing loss, especially considering its link to cognitive decline and dementia. The ACHIEVE study conducted by Johns Hopkins University demonstrated that treating hearing loss with hearing aids can reduce the rate of cognitive decline, particularly among older and less affluent individuals. Researchers also plan to explore the effects of hearing-aid use on brain atrophy, social isolation, depression, and quality of life. While there is some objection to focusing on the connection between hearing loss and dementia, promoting hearing-aid use for greater social interaction and the associated cognitive and mental health benefits is crucial. The FDA has approved certain “self-fitting” hearing aids that users can customize with a smartphone app, but there is still hesitation among those who feel uncomfortable with online sales and do-it-yourself adjustments. Additionally, certain devices that do not require self-fitting do not undergo FDA review. The OTC hearing aids market is still in its early stages, marked by varying price points and confusion among consumers. However, progress has been made, with well-performing OTC aids available for around $1,000 per pair compared to more expensive prescription devices. Despite initial modest sales, major manufacturers like Lexie Hearing are optimistic about the market’s potential. Other manufacturers, like WS Audiology and Sonova, have partnered with consumer companies to increase brand recognition. Best Buy and EssilorLuxottica have also expanded their OTC hearing aids offerings. To guide buyers, independent evaluation and ranking systems like HearAdvisor have emerged. However, there is still room for innovation, lower prices, and further development in the OTC hearing aids market.