Disclosed herein, among other things, are methods and apparatuses for hearing assistance low profile offset spouts. One aspect of the present subject matter relates to a hearing assistance spout consisting of a one-piece spout with a curved path to an off-axis (e.g., offset) port. The spout may be manufactured using metal injection molding to provide for a reflow solder attachment to the hearing assistance microphone. One aspect of the present subject matter relates to placing a full-sized spout off-axis while maintaining an open state that does not restrict the acoustic path, which may allow the offset spout to include a radial seal independent of the microphone body itself. One aspect of the present subject matter relates to an offset spout including a sealed acoustic barrier wall to protect the acoustic inlet of the microphone from debris or moisture.