The objective of this study was to review the practice of next-day cochlear implant activation, or switch-on, after surgery for adult cochlear recipients in northern New Zealand. A retrospective observational study compared next-day and three-week post-surgical outcomes related to early complications, electrode impedance values, speech perception outcomes and the number of patient appointments and speech processor MAPs to the point of stabilisation. Over a five-year period, 167 consecutively implanted recipients were included in this review. Results indicate that less time from surgery to switch-on had no impact on the incidence of wound or fitting complications, and resulted in lower initial impedance measures, fewer hours of follow-up visits and fewer MAPs during the subsequent nine months. Speech perception outcomes did not differ between the early and later switch-on groups. General satisfaction with next-day switch-on practices has resulted in consistent use of this protocol with high patient and clinician satisfaction and improved clinical efficiencies.