BACKGROUND: With an incidence of roughly 1 in 1000 live births, congenital sensorineural hearing loss is one of the most prevalent birth abnormalities. In order to identify the underlying pathology, imaging is commonly used in cases of congenital sensorineural hearing loss. OBJECTIVE: This study was conducted to diagnose different soft tissue lesions, bony lesions and different congenital anomalies of ear by imaging, to detect anatomic variants which are important from the surgical point of view with the help of HRCT and MRI, to identify absolute and relative contraindication for implantation and to help select the best ear for cochlear implantation. MATERIAL AND METHODS A prospective, non-randomized, observational study conducted at B. J. Medical College, Ahmedabad from from July 2018 to December 2020. A total of 70 patients were included over 2 ½ years of time. Each of the temporal bone was analyzed separately and investigator analyzed a total of 140 temporal bones. HRCT temporal bone and MRI cochlea with 7th and 8th nerve drive performed for the purpose of diagnosing or guiding management of hearing loss. RESULTS: According to the study, neither temporal bone CT nor MR imaging of the brain and temporal bones appears to be adequate as the sole imaging modality in all children with hearing loss. Both MRI and HRCT modalities can fill each other’s lacunae. It provides exact information what an implant surgeon wants from radiologist and helps to detect the best ear for implantation and also helps to detect anatomic variants which are important from the surgical point of view. CONCLUSION: Both modalities - Both MRI and HRCT are complementary to each other, so we prefer both modalities are used preoperatively in cochlear implant patients rather than single modality.