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Sponsorships or competing interests that may be relevant to content are dis-closed at the end of this article. Objective. Minimally invasive image-guided cochlear implan-tation (CI) involves accessing the cochlea via a linear path from the lateral skull to the cochlea avoiding vital struc-tures including the facial nerve. Herein, we describe and demonstrate the feasibility of the technique for pediatric patients. Study Design. Prospective. Setting. Children’s Hospital. Subjects and Methods. Thirteen pediatric patients (1.5 to 8 years) undergoing traditional CI participated in this Institutional Review Board–approved study. Three fiducial markers were bone-implanted surrounding the ear, and