Background/Aims: Cochlear implantation is an established intervention for severe to profound sensorineural hearing loss. Although implant design and surgical practice have advanced, some recipients require revision surgery. This study aims to characterise contemporary cochlear implant revision (CIR) patterns to inform implant reliability, patient outcomes, and evolving indications for reimplantation. Methods: A retrospective, single-centre cohort study was conducted at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia, including all CIR procedures performed between 2015 and 2025. CIR was defined as any procedure involving explantation (with or without immediate or staged reimplantation) or device repositioning. Indications for revision were classified as hard failure, soft failure, or medical failure according to current consensus statements. Results: Over the 10-year period, 1820 cochlear implant procedures were performed on 1668 patients, including 63 revision surgeries, corresponding to an overall revision rate of 3.8%. Revision rates were 2.6% among paediatric and 4.1% among adult recipients. The mean interval from primary CI to revision was 8.7 years overall, shorter in paediatric (5.2 years) than adult (9.4 years) cases. Medical failure was the leading indication for CIR (73%), followed by hard failure (24%) and soft failure (3%). Among hard failures, electrode array and insulation failures were the most frequent underlying causes (33% each). Device failure predominated among reimplantation cases (63.4%), whereas medical causes were more common overall. Conclusions: CIR remains an uncommon but clinically relevant occurrence within contemporary practice. Device failure continues to represent the primary indication among reimplantation cases, while medical failures increasingly account for the majority of overall revisions. These findings highlight a shift in revision indications from hardware malfunction toward medical and patient-related causes.