Over the past two decades, clinical experience with cochlear implants has grown, cochlear implant technology and surgical techniques have evolved, and their indications have expanded significantly compared to the past. Who can be considered for a cochlear implant at this time? First of all, it is important to have a proper understanding that cochlear implantation is not just a surgical procedure in which a surgeon implants a cochlear implant into a patient’s body. It requires a team effort that includes the patient, family, school, audiologist, speech/auditory trainer and surgeon. High expectations can often lead to post-operative patient dissatisfaction, which can affect the use of the cochlear implant. All patients and their families should pay close attention to this information and consult with the cochlear implant provider before embarking on this life-changing journey. The next step is to meet the relevant audiological testing criteria. If the subject’s performance is reliable, pure-tone audiometry and speech audiometry are generally used to screen candidates. 12-23 month old children should have a mean pure-tone audiometric threshold of ≥ 90 dB HL in both ears; patients >24 months of age should have a threshold of ≥ 70 dB HL. If the patient can perceive speech in the presence of an audiological device, a speech recognition test with a sound field of 55 dBSPL should be added. Current FDA guidelines allow implantation criteria of ≤ 60% open set sentence recognition (e.g. HINT test) in the best hearing aid listening environment. There are other criteria for testing such as cochlear implantation in patients with prespeech deafness who have been determined to have no improvement in hearing ability after more than 3 months of hearing aid use and aural rehabilitation training. Some congenital or acquired cochlear anomalies identified by imaging may still be candidates for implantation, but they may require special types of cochlear devices, different surgical procedures, and widely varying results. The risk of complications (such as meningitis and cerebrospinal fluid leakage) is also higher than the general population. Thirty percent of children with hearing loss who have a combination of other disabilities, such as blindness, motor balance disorders, Chilean developmental delays, and cranial malformations, were excluded early on and should now be included in cochlear implantation if the hearing device does not help them or is thought to help them after implantation. The emerging criteria for implantation now include people with residual hearing. They are eligible for cochlear implantation if they have a binaural open set phrase recognition rate of ≤ 70% in a quiet environment with optimal hearing assistance or a recognition rate of ≤ 40% in the implanted ear. This selection criterion has been significantly broadened compared to the past. Finally, obvious contraindications to surgery (underdeveloped cochlea or auditory nerve, active otitis media) should be excluded.