Background/Aim. Bone-anchored hearing aids (BAHA^®) are implantable devices that transmit sound through bone conduction directly to the inner ear. They are indicated for patients with conductive or mixed hearing loss who cannot benefit from conventional hearing aids. The aim of this study was to evaluate surgical outcomes, postoperative complications, and audiological improvements following percutaneous and transcutaneous BAHA^® implantation in a pediatric cohort. Methods. A retrospective cohort study was carried out on 20 children who underwent BAHA^® implantation between 2011 and 2024. Demographic data, clinical indications, syndromic associations, audiological findings, and postoperative complications were analyzed. Statistical analyses included Fisher’s exact test and the Wilcoxon signed-rank test, with significance set at p < 0.05. Results. Out of the total of 20 patients (60% male; mean age 6.3 years), 11 received percutaneous and 9 transcutaneous BAHA^® devices. The primary indications were congenital anomalies (50%), notably Treacher-Collins syndrome and isolated atresia. In patients with a percutaneous BAHA^® device, skin infections were recorded in 3 (27%) of 11 patients, and they were accompanied by skin overgrowth, which required revision surgery in 2 (18%) patients. In the group implanted with the transcutaneous BAHA^® Attract device, paresthesia and skin erythema were observed in one case each. The mean hearing improvement was 36.6 dB with percutaneous BAHA^® devices and 31.7 dB with BAHA^® Attract devices at 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz. Significant postoperative hearing improvement was achieved in all patients (p = 0.0002). Conclusion. BAHA^® implantation provides significant hearing rehabilitation in children with conductive or mixed hearing loss. The transcutaneous system demonstrates comparable audiological outcomes with fewer complications and superior cosmetic acceptability compared to the percutaneous system.