<p>Previous studies have shown that hearing loss doubles the risk of depression in older adults, and this parallel, randomized, controlled, open-label trial aims to assess the effectiveness of community health worker-delivered over-the-counter (OTC) hearing aids on depression symptoms in this population. The primary outcome is the change in depression symptoms at 6 months from baseline. Secondary outcomes include communication function, loneliness and social isolation. Older adults aged 60 years or older with mild to moderately severe hearing loss were randomized 1/1 to the OTC hearing aid intervention (<i>n</i> = 109) or a wait-list control group (<i>n</i> = 112) between 1 April and 5 July 2023. Depression symptoms, as measured by the short Geriatric Depression Scale (GDS-15), improved in the intervention group at 6 months (mean difference –1.65; 95% confidence interval 1.18, 1.58; <i>P</i> &lt; 0.001). Similar improvements were seen in communication function, social isolation and loneliness. Approximately 80% of participants maintained &gt;4 hours of hearing aid use per day. No adverse events were reported in this trial. The study demonstrated that community health worker-delivered OTC hearing aids are effective in reducing depression symptoms in older adults with hearing loss. Trial registration: <a href="https://www.chictr.org.cn/">ChiCTR2300069838</a>.</p>