After many years of legislative efforts, standards delays and public comment periods, over-the-counter (OTC) hearing aids are a reality. OTC devices officially became available in October, 2022. Since that time, we have been begun to observe the presence of this instrumentation in consumer electronics stores, chain pharmacies, big box stores and especially on-line. Consumers have been inundated with a constantly evolving portfolio of products ranging in price and quality. Many individuals seeking these devices are unsure which instruments are suitable for their hearing needs and may continue to seek professional guidance while others have applauded the ability to self-manage their communication issues related to hearing loss. As this amplification delivery system is still in its infancy, there are probably more questions than answers for both consumers and hearing healthcare providers. The provision of hearing technology is no longer limited to traditional professionals but rather, the marketplace has embraced independent patient empowerment where decisions to obtain amplification may not be guided by medical providers. Physicians must assess and address the impact these new devices are having on the management of mild to moderate hearing loss and the influence they may have upon clinical practice. This session will review trends and observations of OTC hearing aids after the first year of access and provide suggestions for their management within clinical settings. Options for integrating OTC devices into practice and developing strategies for patients who may have purchased these devices from outside vendors will be addressed. Participants will be encouraged to share their experiences as part of an audience discussion.