A decision aid for parents considering sequential bilateral cochlear implantation for their children with severe-to-profound hearing loss was developed using local and published evidence. Eight parents of children currently using one cochlear implant, who faced a decision regarding a second cochlear implant, and five clinicians involved in the bilateral cochlear implantation decisions participated in a pilot of the decision aid. The decision aid was acceptable to both parents and clinicians. Changes in baseline decisional conflict and knowledge were examined among parents before and after use of the decision aid. Parents had significantly increased knowledge of the bilateral cochlear implant options, risks, and benefits following completion of the decision aid. Decisional conflict did not decline significantly. A decision aid for parents considering sequential bilateral cochlear implantation has potential as a decision support tool. Future work could examine the influence of the decision aid on decisional conflict of various subgroups of parents as well as their expectations of educational and communication outcomes. (Contains 2 figures and 1 footnote.)