OBJECTIVES: To review the outcomes of the cochlear implantation program at King Abdallah Medical Center (KAMC) in Makkah from its launch in 2018 to 2023, focusing on patient demographics, procedural details, and complications. METHODS: A retrospective analysis was conducted on 133 patients who underwent cochlear implantation (CI) at KAMC between May 2018 and June 2023. Data collected included demographics, hearing loss types, anatomical findings from imaging, types of CI devices, procedural challenges, and complications. RESULTS: The average age of the patients was 9 years (108 months) with 56.4% males and 96.2% Saudi nationals. Most patients (50.4%) were from Makkah, and 19.5% had a family history of hearing loss. Med-El implants were used in 63.9% of cases, and 37.6% had simultaneous bilateral implants. Intraoperative complications occurred in 7 (5.3%) patients, while 11 (8.3%) patients experienced postoperative complications. Follow-up adherence was high at 94%, with 18.8% of patients using telehealth services for monitoring. CONCLUSION: The CI program at KAMC has demonstrated to be a safe and effective approach for treating severe-to-profound hearing loss. Minor complications were observed, and follow-up adherence was strong. The study emphasizes the importance of ongoing accreditation and support for the program to ensure its success in hearing rehabilitation.