Purpose of ReviewTo review the current state of development of fully implanted cochlear implants, including a summary of the current challenges and limitations in addition to breakthroughs in technology.Recent FindingsRecent developments towards the realization of a fully implanted cochlear implant draw from technologies that were originally developed for middle ear implants. Advances in the field of implantable microphone technologies and sustainable energy sources have led to the development of a new and novel fully implanted cochlear implant.SummaryAdvances in fully implanted cochlear implant technology are heading towards the realization of commercially available devices. Middle ear microphone technologies provide adequate amplification of sound while avoiding some of the limitations of prior subcutaneous microphones. While a fully implantable sustainable energy source is not yet developed for implantation, several recent studies show promise for eventually eliminating the need for an external charging device.