The increasing degree of sophistication in hearing aid technology calls for appropriate fitting strategies, as otherwise hearing aid users cannot receive the full benefit from the most modern technological achievements. This paper describes the state of the art in hearing aid fitting procedures and offers a look into possible future developments. Currently, threshold-based fitting formula compete with loudness- and sound-based fitting procedures. Whereas threshold-based approaches are straightforward and timesaving, they do not consider loudness growth and the sound preferences of the listener. On the other hand, loudness- and sound-based procedures do take these aspects into account, but they are time consuming and it is not yet proven that they provide higher benefit for the end user. This may be due to the fact that either there is actually no extra benefit or more likely that the evaluation tools or study designs have to be improved. Concerns about how to fit more advanced future hearing instruments seem to be inappropriate, as an analysis of possible future signal processing algorithms shows that they probably do not need extra fitting to the individual hearing impairment but rather need optimization according to the acoustical environment.