Temporal bone virtual reality (VR) simulation training has been shown to be a useful tool for learning mastoidectomy. The authors aimed to evaluate the role of VR in cochlear implant (CI) surgery. The study was performed as part of a four-day cadaver dissection course where all participants received lectures on otosurgery, three hours of VR mastoidectomy training and, subsequently, cadaveric mastoidectomy. They were then randomised into two groups, with the intervention group receiving an additional two hours of CI VR training prior to performing cadaveric posterior tympanotomy and CI insertion. The aim was to assess if skills learnt from VR training were transferred to cadaveric dissection. There was a total of 18 otolaryngology residents who had no experience of independent temporal bone surgery. Surgical performance was assessed using the Cochlear Implant Surgery Assessment Tool (CISAT) and the frequency of the participants requiring instructor guidance/feedback during the dissection. The authors found a slight increase in dissection performance and self-directedness in the intervention group, but the findings were not statistically significant. Interestingly, the improvement in dissection performance following VR CI training was not as clear as following VR training for mastoidectomy. This finding demonstrates that, while VR training is an effective tool for learning mastoidectomy, learning more advanced procedures such as CI is more complex, likely with a longer learning curve.