Cochlear implantation surgery is a precision surgery that involves the common principles of gentle tissue handling, meticulous hemostasis, landmark identification with a thorough understanding of the complex temporal bone anatomy, preservation of critical structures including the facial nerve, and accurate placement of the electrodes in the cochlear lumen. Cochlear implantation surgery, characterized as an aseptic procedure with minimal infection risk, advocates a singular preoperative intravenous antibiotic dose for infection mitigation. Elevated risk factors, such as obesity and diabetes, underscore the importance of prophylaxis, commonly employing a cephalosporin.