Based on a study sample of 1071 primary school children (5.3–11.7 years), 10.2% of the children were found to have conductive hearing loss in 1 or both ears. Binaural speech comprehension scores of a subset of 540 children were analyzed. The results showed that children with bilateral conductive hearing loss had the lowest mean scores of 60.8–69.3% obtained under noise conditions. These scores were significantly lower than the corresponding scores of 69.3–75.3% obtained by children with possible middle ear disorders but no apparent hearing loss, 70.5–76.5% obtained by children with a unilateral conductive hearing loss and 72.0–80.3% obtained by their normally hearing peers. This study confirms that young children, who are known to have poorer speech understanding in noise, show further disadvantage when a bilateral conductive hearing loss is present.