INTRODUCTION: This study evaluates cochleovestibular implants (CVI) for improving auditory and vestibular function in patients with bilateral vestibulopathy and severe-to-profound hearing loss. CVI uniquely combines auditory and vestibular stimulation, offering a potential solution for dual impairments in hearing and balance. METHODS: Ten patients underwent CVI implantation. Auditory function was assessed with pure-tone audiometry (PTA) and speech recognition at baseline, 3, and 9 months post-implantation. Vestibular function was measured using the Dynamic Gait Index (DGI), Sensory Organization Test (SOT), posturography, and the Dizziness Handicap Inventory (DHI). Placebo-controlled tests verified cochleovestibular stimulation specificity. RESULTS: Auditory outcomes showed PTA improvements from 78 dB HL preoperatively to 34 dB HL at 3 months and 36 dB HL at 9 months, alongside speech recognition gains. Vestibular improvements included significant DGI ( DISCUSSION: CVI effectively restores auditory and vestibular function, with improvements in hearing, balance, and quality of life. Neural plasticity likely supports long-term benefits. Future research should refine device design and stimulation protocols to enhance outcomes further.