Aim: To assess the auditory outcomes of cochlear implantation (CI) following treatment of vestibular schwannoma (VS) by stereotactic radiosurgery (SRS) compared with simultaneous cochlear implantation at the time of removal of vestibular schwannoma (SCIRAN) in an Australian cohort of patients. Methods: A retrospective review of the NSW based CI program (NextSense) database was undertaken. Cases of CI post SRS and patients worked up for SCIRAN were included in the study. Data was analysed including pre/post operative audiometric and speech perception scores were recorded and the best post operative speech scores and CI user status.. Descriptive statistics and linear regression analysis was performed. All SRS patients were implanted by single surgeon (CB). All SCIRAN patients underwent translabyrinthine resection of VS by a single surgeon (RE). Results: Fourty-four patients were included. Six patients (13.6%) received SRS, one (2.3%) patient underwent CI without treatment and 37 (84.1%) were worked up for SCIRAN. Three patients were noted to have a diagnosis of neurofibromatosis type 2. Mean tumour size in the SRS group was 14.67mm, compared with 12.96mm in the SCIRAN group. Only 2 tumours in the SCIRAN group were greater than 25mm in maximal dimension. Of the SCIRAN candidates, 26 (70.2%) were able to be implanted at the time of surgery. All 6 (100%) patients treated with SRS, compared with 14 (54%) of the SCIRAN cohort obtained open set speech perception (OSP) and were cochlear implant users. Of the patients that achieved open set speech, there was no significant difference in speech perception outcomes between the two groups. Conclusion: Patients treated with SRS for VS have a greater chance of achieving OSP following CI, than those treated with SCIRAN.