OBJECTIVE: To compare two different percutaneous bone-anchored hearing aid (BAHA) abutment systems regarding operation time, scar healing, quality of life, implant stability, audiologic results, and complications. MATERIALS and METHODS: The study involves a prospective multi-center clinical evaluation. Thirty-two consecutive patients who had undergone BAHA surgery from January 2011 to January 2013 in two tertiary centers were included in the study. The Glasgow Inventory Benefit Score was used to assess the patients at least 6 months after surgery. The operation time and complications were recorded. Implant stability quotient (ISQ) values were recorded using resonance frequency analysis. Holger's classification was used to evaluate skin reactions. RESULTS: The mean length of the operation was 39.2 +/- 4 min for standard abutment and 18.3 +/- 5.7 min for hydroxyapatite-coated abutment. ISQ scores were significantly better for standard abutment in all tests. The mean total Glasgow Inventory Benefit Score was 39.3 +/- 19 for the standard abutment and 46.3 +/- 24.5 for the hydroxyapatite-coated abutment groups, but there was no statistical significance between the two groups. There was no difference in audiological improvement between the two groups after surgery. CONCLUSION: Hydroxyapatite-coated abutment provided a shorter operation time that was significantly different from standard abutment. There were no significant differences between standard abutment and hydroxyapatite-coated abutment regarding audiologic improvement, quality of life, loading time, and complications.