Cochlear implant surgery is a standard treatment for severe-to-profound hearing loss. Accurate postoperative assessment of cochlear electrode is crucial for patient outcomes. Photon-counting CT (PCCT) has emerged as a novel imaging modality that may surpass multi-slice CT (MSCT) in image quality and metal artifact reduction. This study aimed to compare PCCT and MSCT in the radiographic evaluation of postoperative cochlear implantation.