Consistent hearing device use in young children with hearing loss is challenging for families. A hearing aid accessory, called a pilot cap, is often recommended to families to help mitigate the issues around device retention. Although pilot caps are commonly suggested to families, there is sparse data available about how acoustically transparent they are when used with a hearing aid. The purpose of this study was to measure the acoustic transparency when a hearing aid functions under a pilot cap accessory. The Verifit 2 Hearing Aid Analyzer and the Speech Intelligibility Index (SII) were used to measure acoustic transparency related to access of aided speech. Measurements involved four hearing aids that are commonly fit on pediatric patients and four different commercially available pilot caps. SII data were collected at two intensity levels for four simulated sensorineural hearing losses (SNHLs). Response differences between acoustic measurements with a hearing aid plus a pilot cap compared with the hearing aid alone (control) were collected. A total of 80 SII measurements were made. There were 16 SII measurements of the hearing aid alone (control conditions) and 64 SII measurements with combinations of the hearing aids and pilot caps selected for this study. For each hearing aid, there was no significant difference between the SII measurements collected for the hearing aid alone and the hearing aid plus a pilot cap. Additionally, there was no significant difference between the different pilot caps used with each hearing aid tested. Pilot cap use with the four types of hearing aids in this study results in no significant differences in acoustic transparency compared with the control condition. The data in this study support the use of the pilot caps for hearing device retention in children with hearing loss. https://doi.org/10.23641/asha.22647217.