The cochlear implant has not only provided partial hearing to more than 120,000 persons worldwide but also served as a model for successful academic and industrial collaboration. The present chapter reviews the development of modern cochlear implants and the dynamic interactions between academia and industry. The chapter takes a system approach to the cochlear implant system design and specifications. The design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator, and electrode arrays. Safety and reliability issues are considered in the context of the system design and the regulatory requirements. Future directions are discussed with regard to the expanded role of the cochlear implant in treatment of hearing impairment and in development of other neural prostheses.