Background: Hearing aids remain the preferred choice of rehabilitation for the persons with sensorineural hearing impairment which facilitates better speech perception in a quiet environment, but fails to provide better signal to noise ratio (SNR) and give limited benefit in many daily life situations. The use of hearing assistance technology (HAT) along with hearing aids facilitates the communication. The present study is aimed at comparing the need for Hearing Assistance Technology (HATs) in adults with pre and post-lingual hearing impairment. Materials and methods: This cohort study included sample of 105 persons in the age range of 20 to 40 years (mean age = 28.1yrs) with hearing impairment. Subjects were divided in 2 x 2 groups based on onset of hearing loss (prelingual and postlingual) and hearing aids usage (hearing aid users and hearing aid nonusers). The standardized questionnaire tool comprised of two sections viz. general demographic details, and twenty questions based on five domains of daily life viz. interactive communication, non interactive communication, public communications, alerting signals and others were used to find the difficulty felt and perceived need for use of HATs. Results: On the basis of qualitative analysis postlingual group (mean score=42.57) felt more difficulty and perceived need for HATs compared to prelingual group (mean score=36.41). Within subgroups of prelingual, hearing aid users felt more difficulty and perceived need for HATs where as in postlingual subgroups hearing aid non users felt more difficulty and perceived need for HATs. Conclusion: The post lingual group felt more difficulty, and perceived need for HATs as compared to prelingual group. Hence it can be inferred that postlingual were dependent upon auditory based communication modalities and age of onset of hearing loss has significant influence on the difficulty felt and perceived need for HATs. Further it also depends upon the usage of the hearing aids. Key words: Hearing Assistance Technology (HAT), Prelingual, Postlingual, Hearing Impairment, and Rehabilitation