Background <p>Ototoxicity caused by aminoglycosides like kanamycin and amikacin used in the treatment of MDR TB has devastating effects on their life. These negative impacts can be reduced with proper aural rehabilitation. Cochlear implant is a part of aural rehabilitation which is found effective in cases who are not benefited with hearing aids; hence, cochlear implant’s long-term effectiveness in its users are important to be identified and documented.</p> Case presentation <p>Three young adults with MDR TB who developed hearing loss after treating with kanamycin/amikacin are considered. All of them were getting poor benefit with hearing aids and underwent cochlear implantation. Responses with cochlear implant were excellent and its long-term effect also showed reduction in the disabilities and handicap 5&#xa0;years post-implantation.</p> Conclusion <p>Cochlear implantation is successful in MDR TB cases with kanamycin/amikacin-induced ototoxicity.</p>