Hearing loss (HL) affects the quality of life, with significant impacts on health, communication, social, and emotional interactions, leading to isolation and difficulties in social activities. Communication, the most common challenge reported by individuals with HL, involves the integration of various sensory inputs. Accurate assessment of communication ability involves not only evaluating how well speech is heard but also understanding how different sensory inputs are processed in the brain. Using the functional near-infrared spectroscopy (fNIRS) technique as an objective method, this pilot study explored speech performance and the activation patterns of the anterior prefrontal cortex (APFC) in individuals with normal hearing (NH) and HL. Twenty-six participants (14 with NH and 12 with HL) completed speech and fNIRS testing in auditory only (AO), visual only (VO), and audiovisual (AV) conditions with five trials per condition. The participants completed a listen-and-repeat task and speech performance was evaluated using percent-correct scores. Hemodynamic responses in APFC were analyzed to investigate the activation patterns in each test condition. Both groups showed the best speech performance in AV, followed by AO and VO. While the NH group showed better speech performance than the HL group in AV and AO, the HL group showed better performance in VO. In terms of APFC activation patterns, both groups exhibited activation in the right anterior medial PFC across AO, VO, and AV, but in VO, the HL group showed activation in that left anterior lateral PFC. These pilot study results are consistent with previous findings showing that individuals with HL exhibit lower speech performance and the provision of visual information is beneficial for speech understanding regardless of HL. However, different patterns of APFC activation observed through fNIRS indicate that the areas engaged in processing various sensory inputs during communication may differ depending on the presence of HL.