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Objectives: We asked what were the characteristics of children with single sided deafness (SSD) who become candidates for unilateral cochlear implantation (uCI). Study Design: Retrospective review. Methods: Records of 73 children with short duration (< 4years) SSD presenting for uCI candidacy assessment to a tertiary pediatric children's hospital from 2013-2017 were reviewed. Demographics, radiological studies, audiological data, hearing loss etiology and parental decision to proceed with implantation were examined. Results: 73 children with SSD were reviewed. 64 children had completed and 9 were in the progress of candidacy assessment at the time of review. Many (20/64, 31%) did not meet candidacy criteria for implantation, most because of cochlear nerve aplasia/hypoplasia (17/49, 34%) and because 21/64, 32% of families elected not to go forward with implantation. The most common etiologies of SSD in the 23/64 (36%) children who both met candidacy and consented to implantation were congenital cytomegalovirus (cCMV) (10/22, 45%), trauma (4/22, 18%) and cochleovestibular anomaly (3/22, 14%). Conclusions: Many children with unilateral deafness who present for implant candidacy assessment do not ultimately receive uCI. Major factors contributing to non-candidacy are cochlear nerve aplasia and parental decision. Of the proportion of children with SSD (~50%) who are candidates for implantation, most have hearing loss associated that is sudden in onset or carries risk of progressive deterioration in the better hearing ear. These findings provide important insight into this new population of cochlear implant users and the emerging acceptance of this intervention. [ABSTRACT FROM AUTHOR]