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The power consumption of digital hearing aids is very restricted due to their small physical size and the available hardware resources for signal processing are limited. However, there is a demand for more processing performance to make future hearing aids more useful and smarter. Future hearing aids should be able to detect, localize, and recognize target speakers in complex acoustic environments to further improve the speech intelligibility of the individual hearing aid user. Computationally intensive algorithms are required for this task. To maintain acceptable battery life, the hearing aid processing architecture must be highly optimized for extremely low-power consumption and high processing performance.The integration of application-specific instruction-set processors (ASIPs) into hearing aids enables a wide range of architectural customizations to meet the stringent power consumption and performance requirements. In this thesis, the application-specific hearing aid processor KAVUAKA is presented, which is customized and optimized with state-of-the-art hearing aid algorithms such as speaker localization, noise reduction, beamforming algorithms, and speech recognition. Specialized and application-specific instructions are designed and added to the baseline instruction set architecture (ISA). Among the major contributions are a multiply-accumulate (MAC) unit for real- and complex-valued numbers, architectures for power reduction during register accesses, co-processors and a low-latency audio interface. With the proposed MAC architecture, the KAVUAKA processor requires 16 % less cycles for the computation of a 128-point fast Fourier transform (FFT) compared to related programmable digital signal processors. The power consumption during register file accesses is decreased by 6 %to 17 % with isolation and by-pass techniques. The hardware-induced audio latency is 34 %lower compared to related audio interfaces for frame size of 64 samples.The final hearing aid system-on-chip (SoC) with four KAVUAKA processor ...