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INTRODUCTION To compare the audiological results of Bone Conduction Hearing Aid (BCHA) on hard test band and Bonebridge (BB) implant among children with microtia and atresia. METHODS This is a retrospective review of patients with microtia and atresia who underwent BB implant insertion from September 2014 to February 2017 in Starship Children's Hospital. Preoperative audiological testing using a powered BCHA (Oticon Medical Ponto Pro Power) on a hard test band was used to compare post-operative hearing assessments with the BB. RESULTS Ten microtia and atresia patients were treated with a BB of whom three were treated bilaterally The children were aged between 5 and 15 and all had moderate to moderately severe conductive hearing loss. For each ear tested and subsequently implanted, BB aided speech scores were equivalent to that obtained by a BCHA. The mean improvement of speech reception threshold level between unaided and BB was statistically significant (p > 0.0001). Subjective questionnaire data indicated that BB implanted patients were performing within the norms of overall listening, both in quiet and in noise. Aided Speech In Noise (SIN) testing values were found to range from 0.8-6.5 for BCHA and 0.2-1.2 for BB and the difference was not statistically significant with a p value of 0.143. CONCLUSION In audiologic assessments BB performs comparably to BCHA among children with microtia and atresia.