OBJECTIVE: Electrode array design may impact hearing outcomes in patients who receive cochlear implants. The goal of this work was to assess differences in post operative speech perception among patients who received cochlear implants of differing designs and lengths. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary Care Hospital. METHODS: Patients (n = 129) received 1 of 9 electrode arrays, which were categorized by design: Lateral wall electrodes (n = 36) included CI522, CI622 (Cochlear Americas), Flex24, and Flex28 (Med El). Midscala electrodes (n = 16) included HiRes Ultra 3D (Advanced Bionics). Perimodiolar electrodes (n = 77) included CI512, CI532, CI612, and CI632 (Cochlear Americas). Speech perception was evaluated using consonant-nucleus-consonant (CNC) tests and at 3, 6, 12, and 24 months postimplantation. RESULTS: Perimodiolar electrodes showed significantly higher CNC scores compared to lateral wall electrodes at 6 and 24 months. Perimodiolar electrodes also outperformed midscala electrodes at 12 months. An inverse relationship was observed between electrode length and CNC scores noted at 6, 12, and 24 months. CONCLUSION: Perimodiolar electrode arrays, which tend to be shorter, demonstrated better speech perception outcomes compared to the longer lateral wall and midscala arrays at some timepoints. These findings suggest a potential advantages of perimodiolar electrodes for optimizing hearing outcomes.