Objectives: The speculation that degenerative processes in the aging central nervous system may impede speech perception after cochlear implantation (CI) has frequently limited candidacy of the patients with advanced age for CI. The aim of the present study was to compare speech perception performance after CI and its potential contributing factors between younger (aged < 65 years) and older (aged ≥ 65 years) recipients. Methods:Only the subjects who received unilateral implants between 2005 and 2014 in Seoul St. Mary’s Hospital and completed 1-year follow-up speech outcome assessment were included in this study. Speech perception was evaluated using open-set spoken word (mono- or disyllable) and sentence recognition tests through auditory-only signal presentation in quiet. Clinical and preoperative audiologic factors (age, sex, level of education, duration of deafness, duration of hearing aid use, bimodal hearing, PTA, speech test scores, number of channels, number of speech therapy, and patient’s motivation) were analyzed. Result:The older group comprised 21 subjects, and the younger group, 25 subjects. Postoperative medical and surgical complications were not apparent in the older group. All the relevant factors listed above were not significantly different between the two age groups. Speech perception performances and PTAs of the older were not different from those of the younger after CI. Eighty-six/seventy-six percent of the older/younger recipients obtained the sentence recognition scores of 50 or more without statistical difference. Conclusion:The elderly CI recipients demonstrated no problematic complications. They showed improved speech performances that equaled those of the younger recipients. We suggest that CI can be performed actively and effectively to improve the quality of life in the older hearing-impaired people.