How does hearing loss affect perception and understanding of music? It is not as simple as turning down the volume on sound. Sensorineural hearing loss (with causes ranging from neurotoxic drugs to aging to genetics) involves damage to the inner ear and can result in different degrees and configurations of hearing loss. For example, when people age they might gradually lose high-frequency hearing but have no problem hearing low frequencies. Moreover, the technologies involved with assistive listening devices such as hearing aids and cochlear implants do not simply turn up the volume of sound. These aids can be programmed to process incoming sound in particular ways to amplify certain frequency bands. Hearing aids and cochlear implants were originally designed to benefit speech understanding, but engineers have begun to develop technologies to benefit music listening as well. Although tests of music perception are not included in routine examinations of hearing, clinicians are becoming more interested in how music can enhance quality of life. Finally, studying music perception in people with hearing loss can help answer questions regarding the effects of auditory deprivation on what some call the “universal language.”