<p>Auditory neuropathy spectrum disorder (ANSD) is a complex auditory disorder characterized by an absent or abnormal auditory brainstem response (ABR) despite normal outer hair cell function. Individuals with ANSD often experience significant challenges in speech perception, particularly in noisy environments, which complicates the choice of appropriate rehabilitation strategies. This systematic review aims to evaluate the benefits and limitations of hearing aids in individuals with ANSD, for improving auditory outcomes. The review includes studies published between 2010 and 2025 that assess the impact of hearing aids on speech perception in individuals diagnosed with ANSD. Results indicate that while hearing aids may offer limited benefits for some patients, particularly those with mild neural dys-synchrony and preserved cortical responses, their effectiveness is generally unpredictable and less significant in noisy environments. Certain hearing aids, such as channel-free devices, have shown better outcomes than traditional multichannel hearing aids. These findings are presented to provide a broader clinical context for rehabilitation options. The findings highlight the need for individualized assessments to determine the most suitable rehabilitation option based on the degree of neural dys-synchrony, speech discrimination abilities, and auditory environment challenges. Overall, the evidence highlights the importance of individualized assessment in ANSD management. Hearing aids may be beneficial for a subset of individuals, but their limitations must be carefully considered, particularly in relation to neural timing deficits and listening environments<b>.</b></p>