Although individual responses to cochlear implants are highly variable and depend on several physical and psychosocial factors, the trend toward improved performance with increasingly sophisticated electrodes and programming strategies has dramatically expanded indications for cochlear implantation. Although cochlear implants originally were touted as an aid to speech reading for individuals with profound hearing impairment, a growing population of implanted patients are exceeding their preoperative hearing performance (which was aided with conventional hearing aids). Due to the overall success of cochlear implant and ongoing advances in performance, an article addressing indications for cochlear implantation attempts to describe a target that moves almost yearly.