Objective To evaluate the value of preoperative temporal high resolution computed tomography (HRCT) and inner ear MRI in cochlear implants (CI). Methods A total of 104 cases (110 ears) of patients with sensorineural hearing loss (SNHL) who were scheduled to undergo CI therapy were given HRCT and MRI. The examination effects of the two examination methods on the anatomy of inner ear and related lesions were analyzed. Results The detection consistency of temporal HRCT and MRI was good in acute suppurative otitis media, large vestibular aqueduct syndrome and cochlear dysplasia, and the detection consistency was fair in neurofibroma, common cavity malformation, Mondini malformation, poor mastoid gasification and deepened or forward migration sigmoid sinus, but the detection consistency was poor in Michel malformation, inner auditory canal cochlear nerve loss, cochlear non-development, ossification labyrinthosis, cystic-vestibular malformation and high jugular bulb. There was no significant difference in the anatomic values and anatomical measurements of each item by temporal HRCT (P>0.05). Conclusion Temporal HRCT and MRI for preoperative examination of CI can clearly and objectively show the structure and abnormalities of inner ear and surrounding anatomy, and can provide accurate reference for surgical treatment, but the two methods have their own advantages and disadvantages, and combined application can achieve complementary effects, and has important significance for improving the accuracy of diagnosis and treatment effects.