To determine the importance of fundamental hearing aid attributes and to elicit measures of satisfaction and dissatisfaction. A prospective study based on a survey using a decompositional approach of preference measurement (conjoint analysis). Ear, nose, and throat university hospitals in Cologne and Giessen; various branches of hearing aid dispensers. A random sample of 175 experienced hearing aid users aged 20 to 91 years (mean age, 61 yr) recruited at two different sites. Relative importance of different hearing aid attributes, satisfaction and dissatisfaction with hearing aid attributes. Of the six fundamental hearing aid attributes assessed by the hearing aid users, the two features concerning speech perception attained the highest relative importance (25% speech in quiet, 27% speech in noise). The remaining four attributes (sound quality, handling, feedback, localization) had significantly lower values in a narrow range of 10 to 12%. Comparison of different subgroups of hearing aid wearers based on sociodemographic and user-specific data revealed a large interindividual scatter of the preferences for the attributes. A similar examination with 25 clinicians revealed overestimation of the importance of the attributes commonly associated with problems. Moreover, examination of satisfaction showed that speech in noise was the most frequent source of dissatisfaction (30% of all statements), whereas the subjects were satisfied with speech in quiet. The results emphasize the high importance of attributes related to speech perception. Speech discrimination in noise was the most important but also the most frequent source of negative statements. This attribute will be the outstanding parameter of future developments. Appropriate handling becomes an important factor for elderly subjects. However, because of the large interindividual scatter of data, the preferences of different hearing aid users were hardly predictable, giving evidence of multifactorial influences.