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Aim Report our preliminary experience with an alternative technique for cochlear implantation. Setting Tertiary referral cochlear implant center. Study design Retrospective case series. Subjects and method Fifteen patients have been operated using incus buttress approach. The procedure involves classical cortical mastoidectomy and identification of short process of the incus. Bony incus buttress was removed moving inferiorly toward facial recess. Round window was identified then marginal cochleostmy was performed and finally insertion of the electrode into the cochlea via the widened aditus. Results Fifteen implants were performed on 15 patients. All were children (mean age of 3.2 years). All the children were pre-lingual. A Med-el SONATA implant (MED-EL, Innsbruck, Austria) was used in all patients. Mean duration of surgery was 12015 minutes. The minimum follow-up was 6 months. No complications were observed during the procedure or during postoperative follow-up. Conclusion Here, we describe a new alternative technique for cochlear implantation and report our preliminary results. The procedure has advantages over the existing alternatives techniques and avoids the potential complications of posterior tympanotomy.