Research findings are reviewed and clinical issues and options regarding binaural hearing aid fitting are discussed. The most defensible options are: (1) fit all cases binaurally unless specifically contraindicated, or (2) fit cases that demonstrate binaural advantage on one or more selected tests. Some common beliefs about binaural fitting (e.g., that it is especially helpful for hearing in noise) are questioned. It is also argued that some of the methods suggested for speech discrimination testing of binaural fitting candidacy may be unreliable, invalid, or uninformative.