Aims: This study evaluates speech perception and quality of life (QoL) outcomes in cochlear implant (CI) recipients from Australia and Spain. Using the International Classification of Functioning, Disability, and Health (ICF) framework, we explore how implant type, electrode type, and cultural context affect these outcomes. Methodology: A cross-sectional study of 508 CI recipients (266 from Australia, 242 from Madrid) with various MED-EL implant and electrode types was conducted. The Glasgow Benefit Inventory (GBI) assessed QoL across social, physical, and general well-being subscales. Speech perception in noise was evaluated, and multivariate regression identified predictors including implant type, electrode type, and cultural setting. Results: Participants with newer implants and flexible electrodes reported higher QoL, particularly in social and general well-being subscales (p < 0.001). Australian participants showed higher QoL scores (t = 2.43, p = 0.015), possibly due to environmental and social support differences. Multivariate analysis identified implant and electrode types as significant QoL predictors (β = 0.35, p < 0.001 and β = 0.28, p < 0.001), while age-influenced speech perception improvements (β = -0.22, p = 0.004). Conclusion: Implant and electrode selection play a crucial role in enhancing QoL and speech perception outcomes for CI recipients. The ICF framework provided insights into the cultural and device-related factors affecting patient experiences. These findings advocate for personalized rehabilitation strategies and underscore the need for international assessment tools that enable outcome comparison and data integration across diverse populations, promoting inclusive and effective CI care.