The treatment of deaf and hearing-impaired children with cochlear implants has been established for several years. Nonetheless, no long-term results exist for studies of a representatively large number of children in the German-speaking area. These are necessary in order to formulate prognoses regarding the development and results of children undergoing implantation at various ages. In a retrospective study, we assessed the data of 156 children with various implantation ages and a minimum follow-up period of 5 years for whom speech and audiological data (Oldenburg Sentence Test, Freiburg words/numbers test) were available. Our findings confirm the assumption that early-implanted children (<2 years) achieve the best speech-comprehension results. For this reason, support for a sufficient universal neonate hearing screen should be emphatically given so that implantation, after a hearing test phase, can be targeted in the first year of life. The surgical, anesthesiological, and rehabilitation conditions must be fulfilled, and surgical experience is required for operation on infants and small children.