This session will highlight emerging concepts in cochlear implantation that improve clinical outcomes including preservation of low frequency hearing and implantation of patients with unilateral hearing loss. Data will be presented that demonstrate enhanced central auditory processing and hearing in complex listening environments with preserved low frequency hearing. We will discuss how new technologies help develop individualized surgical plans based on pre-operative imaging parameters (e.g. cochlear length), genetic profile, etiology of hearing loss, and age. We will discuss the clinical use of technologies that have recently been introduced that enable improved preservation of cochlear structures and customized rehabilitation strategies. These include pre-operative and post-operative image based planning tools, intra-operative and post-operative electrophysiological measures (e.g. electrocochleography and advanced impedance measures), robotics assisted electrode array insertion, dexamethasone eluting electrodes, and customized electrode arrays. Integration of these technologies to develop a comprehensive strategy will be demonstrated. Finally, we will conclude by highlighting technologies currently in preclinical development such as novel biomaterials, immunomodulatory drugs, and approaches to preserve neural function.