Purpose <p>The purpose of this study was to evaluate gross motor competence in children with cochlear implants (CI) compared with normal-hearing (NH) peers and to determine whether CI use is associated with differences in gross motor competence.</p> Methods <p>A total of 44 children aged 4–7 years were enrolled, including 22 unilateral CI users and 22 age- and sex-matched children with NH confirmed by audiological assessment. Gross motor skills were assessed using the Test of Gross Motor Development–2 (TGMD-2), yielding locomotor, object-control, and total gross motor scores based on standardized qualitative criteria.</p> Results <p>NH children demonstrated significantly higher performance than children with CI across locomotor, object-control, and total TGMD-2 scores (all <i>p</i> &lt; .001). Skill-level analyses revealed significant group differences for most gross motor skills (<i>p</i> &lt; .05), except gallop (<i>p</i> = .086) and catch (<i>p</i> = .711). Age had a significant effect on performance (<i>p</i> &lt; .001), with older children achieving higher scores, whereas no significant gender effects were observed (<i>p</i> &gt; .05).</p> Conclusion <p>Children with CI exhibited significantly poorer gross motor performance than their NH peers across TGMD-2 domains, with deficits evident in most locomotor and object-control skills. Age-related differences in performance were observed, with older children demonstrating higher scores. These findings underscore the importance of incorporating motor assessment and targeted intervention into the clinical management of children with CI.</p>