Hydrogenated amorphous silicon (a-Si:H) films were irradiated with 1-MeV Si+ ions. The accumulation and annealing of ion damage was investigated by Raman scattering, optical reflection and transmission, and conductivity measurements. For damage levels up to 0.003 displacements per atom, electrical defects are created with no measurable effect on the structural properties. These defects can be completely annealed out at 180°C. Further irradiation results in an increase in the average bond-angle variation in the films. This structural disorder causes a decrease of the optical band gap with 0.46 eV. The structural changes caused by high-dose implantation can not be reversed by annealing at 180° C, which results in the formation of anneal-stable electrical defects.