The occurrence of Vestibular Schwannoma (VS) associated with cholesteatoma is rare and hearing impairment is one of the most significant issues in such cases. Moreover, the presence of middle and inner ear pathologies combined may represent a surgical challenge. This video presents a female patient who underwent successful simultaneous surgical treatments for VS and middle ear cholesteatoma in the right ear followed by a cochlear implant, describing the technique and further audiological results. The surgical approach enabled the resection of lesions with auditory nerve and cochlea preservation. Cochlear implantation in the right ear showed positive postoperative results, with an improvement in the results with the CI in silent and noisy environments.