Eighty-four adult cochlear implant (CI) users were compared with 3 other groups of severely to profoundly hearing impaired adults concerning quality of life (QOL): 1) 19 CI candidates who were accepted as candidates for implantation, but who were not operated on; 2) 16 CI candidates whose impairment was not severe enough for implantation; and 3) 60 users of acoustic hearing aids. Generic and disease-specific QOL questionnaires were used. The CI group scored significantly better than the CI candidates who met the criteria for implantation, but who were not operated on, on 2 of 6 categories of a disease-specific QOL measure. The CI patients had significantly less anxiety and depression than the unoperated CI candidates who met the criteria for implantation. Validation and reliability testing of 2 disease-specific QOL measures were performed by factor analyses.