Although cochlear implantation is considered a safe method of rehabilitation for profoundly deaf individuals, a number of these patients suffer complications after surgery. To evaluate post-operative complications after cochlear implantation, a retrospective chart review was performed for 112 patients who had undergone implantation in the Maastricht Academic Hospital. Minor complications were defined as those that could be overcome by medical or audiological management. These occurred in 36 patients (32 per cent) and all were managed successfully. Major complications were defined as device extrusion and those requiring further surgery, and these were identified in four patients (3.6 per cent). These complications included wound infection and device failure mediated by middle-ear pathology. In cases of chronic otitis media, we recommend performance of cochlear implantation as a staged procedure. In order to reduce the post-operative incidence of acute otitis media, we recommend adenoidectomy, placement of ventilation tubes and early antibiotic treatment.