Objective: The aim of the study was to develop and validate a monosyllabic 50-word speech-in-noise test to be used in hearing aid fitting for comparison of speech recognition performance in the aided and unaided listening condition. Study design: One hundred and two adult hearing aid users were included in the study and tested at the final visit of their hearing aid fitting process. A speech recognition test, comprising the Swedish PB lists mixed with a standardized multi-talker noise, was performed with and without hearing aids. The International Outcome Inventory for Hearing Aids (IOI-HA) was also administered to the patients and the audiologists provided their evaluation of the test in a post study survey. Results: The speech recognition scores revealed a statistically significant hearing aid benefit for 77% of the subjects; however, this objectively measured benefit was not significantly correlated to the total IOI-HA results. This would indicate that the two different tests demonstrate different aspects of the rehabilitation outcome and that the one cannot predict the outcome of the other. The speech-in-noise test was considered to be applicable as well as practical for clinical use. Conclusion: The results of this study show that a monosyllabic speech-in-noise test would provide valuable information in the hearing aid fitting process, in addition to already established quality measurement methods, i.e. ear canal measurements and outcome inventories.