Between 2000 and 2006, the University Clinic for Ear Nose and Throat and Communication Disorders in Mainz, Germany, performed 41 bilateral cochlear implantations in children. This article addresses some of the factors to be considered in a decision to bilaterally implant a child, including the age of the child at the first implant, the length of time between the first and second implants, the age of the child at the time of the second implant and the level of auditory learning experienced with the first implant. At the time the article was written, 33 of the first 41 children were able to participate in speech discrimination testing in quiet and in noise. The children's localization abilities were also reported. All of the tests concerning hearing, localization and speech understanding with the implants were conducted as part of the child's regularly scheduled appointments to verify the settings of each speech processor and the performance with both implants. The information shared in this article reflects findings from clinical practice and was not obtained in a controlled research protocol. Nevertheless, the experiences and observations reported are clinically relevant to those involved in or contemplating bilateral cochlear implantation of young children.