Various types of bone conduction hearing aids have been widely used for hearing rehabilitation for the last 30 years. Among them, the recently launched Osia ® 2 system is a new active transcutaneous bone conduction implant system using piezoelectric effect. This can be expected to deliver more efficient sound transmission, overcome sound attenuation, and improve high-frequency hearing than conventional passive transcutaneous hearing aids, and is considered to be cosmetically superior to percutaneous hearing aids. Recently, we experienced two cases of Osia ® 2 implantation in patients with iatrogenic unilateral hearing loss. Both patients showed improved pure tone threshold and better Korean Hearing in Noise Test (K-HINT) score after implantation. Furthermore, all of them had no complications after Osia ® 2 implantation.