Background: Advancements in cochlear implant technology and improved hearing outcomes have driven the evolution of candidacy criteria for adults with postlingual hearing loss. The revised guidelines, building on the 2016 framework, now integrate adaptive sentence recognition in noise (SRT) as a central tool for audiological assessment, reflecting the complexity of real-world listening environments. Methods: A retrospective review was performed on adult cochlear implant recipients at the Royal Victorian Eye and Ear Hospital. Outcomes were analysed for patients using contemporary implant systems, focusing on open-set monosyllabic word and phoneme scoresas well as adaptive sentence recognition in noise (AuSTIN SRT). Results: Adults with a pure-tone average (PTA) ≥70 dBHL and phoneme score ≤63% in the worse ear are now considered suitable candidates for cochlear implantation. Among 316 adults assessed 12 months post-operatively, mean CVC word and phoneme scores were 48% and 70%, respectively, with 75% exceeding 34% (words) and 63% (phonemes). The median AuSTIN SRT was 8.8 dB, with 75% of recipients achieving better than 13.5 dB. These data demonstrate a ≥75% probability of significant speech perception improvement following cochlear implantation, supporting the revised criteria. Incorporating SRT-in-noise testing enhances the functional assessment of candidates, especially those with residual or asymmetric hearing loss. Conclusion: The updated candidacy guidelines for adult cochlear implantation, including SRT-in-noise, align with current audiological assessment and real-world patient needs. These changes expand access to cochlear implantation and support optimal outcomes for adults with postlingual hearing loss, reinforcing the role of evidence-based criteria in candidate selection. Keywords: Otology, Cochlear implantation, Surgical candidacy, Speech perception, SRT in noise