Purpose: The purpose of this study was to measure auditory comprehension performance in school-aged children with unilateral hearing loss (UHL) and with normal hearing (NH) in quiet and in the presence of child-produced two-talker babble (TTB). Method: Listeners were school-aged children (7-12 years) with permanent UHL (n = 25) or NH (n = 14). Comprehension of three short stories taken from the Test of Narrative Language (Gillam & Pearson, 2004) was measured in quiet and in the presence of TTB at two signal-to-noise ratios (SNRs): (a) +6 dB and (b) the individualized SNR required to achieve 50% sentence understanding in the presence of the same TTB masker in a prior study (Griffin, Poissant, & Freyman, 2019). Target/masker spatial configuration was 0°/±60° azimuth. Results: As a group, subjects with UHL demonstrated auditory comprehension abilities in favorable listening environments (i.e., quiet, +6 dB SNR) that were statistically equivalent to the NH group. However, in the most challenging listening condition (individualized SNR), many subjects with UHL demonstrated poorer comprehension performance than their age-matched peers with NH. Comprehension abilities were not associated with degree of UHL, unaided speech intelligibility index at 65 dB SPL in the impaired ear, side of UHL, or sex. Conclusions: As a group, children with UHL demonstrated deficits in auditory comprehension compared to age-matched peers with NH in challenging listening environments. Findings highlight the importance of ensuring good SNRs for children with UHL.