Cochlear implantation (CI) in patients with single-sided deafness (SSD) has been carried out in Perth, Australia from 2008. It poses challenges to clinicians and patients who are trying to tune in the poorer ear while still having a normally hearing ear on the other side that the brain naturally focuses on. Rehabilitation of these patients is different to typical cochlear implant patients. As the normal-hearing ear cannot be ‘switched off’ the rehabilitation material is presented via a direct audio input. This paper describes the different types of rehab material used in the authors’ CI centre from bottom-up ‘analytical’ tasks such as words in isolation or simple sentences, to top down ‘synthetic’ training focusing on larger amounts of speech material including audio books and watching documentaries. As is the case with typical CI users, length of profound deafness and patient motivation are key factors to success. Therefore, candidates are carefully counselled pre-implantation regarding the amount of work or training needed. The team feel that the CI should not only be worn full-time but also a minimum of 20-30 minutes of formal auditory training per day should be undertaken. Only when 100% accuracy is achieved on open set speech tasks should training step down to fortnightly/monthly. The team have had very few non-users (five in total) out of 114 implanted with SSD, which is a high level of compliance. This indicates that if patients are fully aware of their expectations of use and training and engage with intensive and structured auditory training programmes, successful outcomes can be achieved with SSD. These techniques could also be applied in other challenging cases.