Cochlear implants have become the standard of care for patients suffering from profound sensorineural hearing loss. Unfortunately, access to cochlear implantation as well as cochlear implant rehabilitation may be limited. In order to facilitate access to cochlear implantation and cochlear implant rehabilitation, implantation was performed at a satellite medical facility over 250 miles from the Carolina Ear and Hearing Clinic's cochlear implant center, and the implants were programmed over the Internet via a virtual private network (VPN). A separate video conferencing system was used to insure synchronization of the video and audio signals. Initially, an IRB approved pilot study was conducted comparing the postoperative HINT and CNC word scores for seven patients who had undergone remote mapping and programing of their cochlear implants. Their scores were compared with the mean scores of seven patients who had been programmed at the Carolina Ear and Hearing Clinic by the same audiologist over a twelve-month period. All patients in each group were successfully programmed and there were no statistically significant differences in postoperative HINT and CNC word scores. Based on the success of this pilot study, the remote programming system was expanded to include young children. Their ages ranged from 22 months to 5 years of age. All five children were successfully programmed remotely. To date, over 48 adult and pediatric patients have been implanted and successfully programmed using this remote programming system. The ability to remotely program cochlear implant patients offers the potential to extend cochlear implantation to areas without a tertiary cochlear implant center. This model, which is safe, effective, and maintains patient confidentiality, may have application for other implant centers attempting to provide patients access to cochlear implant technology.