Devices that amplify sound are essential for managing hearing impairment. Most hearing impairments can be treated with a modern hearing aid. Cochlear implants are surgically implanted devices that electronically stimulate the auditory nerve in the cochlea to provide hearing. Criteria for cochlear implant selection include moderate to severe sensorineural hearing loss and a patient who still struggles to hear and understand despite the hearing aids being properly adjusted. Advances in cochlear implants and the surgical technique of cochlear implants have a long history full of innovations that have resulted in better surgical technique approaches, fewer complications, and improved recovery. This review aims to make an update on the surgical technique of cochlear implants.