Purpose Current recommendations for clinical management of school-aged children with limited useable hearing unilaterally primarily focus on remote microphone systems and preferential seating. The purpose of this narrative review is to examine the existing evidence supporting these recommendations. Method A narrative review was conducted, focused on nonsurgical interventions for children with limited useable hearing unilaterally. Results Six articles were identified. Three survey studies suggest high use rates and improved academic performance with contralateral routing of signal systems. One laboratory study suggests students with hearing loss need to sit closer to the desired signal (e.g., teacher) than their peers with normal hearing to achieve similar speech recognition. Two laboratory studies suggest remote microphone systems provide consistent benefits when the microphone is located near the talker of interest, whereas contralateral routing of signal systems impairs performance in noise. Conclusions The discrepancy between survey studies and laboratory studies could be explained partly due to the difference between listening situations in the laboratory and in classrooms. Everyone in the classroom is a potential talker of interest, and the listening environments are often dynamic. Thus, contralateral routing of signal systems might have more potential to improve classroom communication than was suggested by the laboratory studies. Recommendations for microphone technologies should be based on the extent to which a student is struggling, where the student sits in the classroom, and where the important talkers are located. There is not one optimal recommendation for all students, but a combination of remote microphone and contralateral routing of signal systems could work for most students. Supplemental Material https://doi.org/10.23641/asha.9956663.