Connors JR, Deep NL, Huncke TK, et al. - In this retrospective chart review, researchers reported the outcomes on a large series of elderly patients who had cochlear implantation (CI) surgery under local anesthesia with conscious sedation (LA‐CS). Between August 2013 and January 2020, 100 consecutive elderly patients (> 65 years) who had CI with LA‐CS at a tertiary care center were included. No patients in the LA‐CS group encountered cardiopulmonary adverse events, whereas the general anesthesia (GA) group encountered minor events like atrial fibrillation and/or demand ischemia in three patients (6%). Compared with GA, the average amount of time spent in the operating room was 37 minutes less for procedures performed under LA‐CS. Cochlear implant surgery under LA‐CS provides many advantages, and when conducted by skilled CI surgeons, it is a safe, feasible, and cost-effective alternative to GA.