Objective-Comparison of the Cincinnati criteria (midpoint >0.9 mm or operculum >1.9 mm) to the Valvassori criterion (midpoint ≥ 1.5 mm) for enlarged vestibular aqueduct (EVA) in pediatric cochlear implant patients. Study Design-Cohort study Subjects-130 Pediatric cochlear implant recipients.Methods-We reviewed temporal bone CT scans to measure the vestibular aqueduct midpoint and opercular width.Results-The Cincinnati criteria identified 44% of patients with EVA versus 16% with the Valvassori criterion (P<0.01). Of those with EVA, 45% were unilateral and 55% were bilateral using Cincinnati criteria; 64% were unilateral and 36% bilateral using Valvassori criterion (P<0.01). The Cincinnati criteria diagnosed 70 ears with EVA classified as normal using the Valvassori criterion (P<0.01);59 lacked another medical explanation for their hearing loss. Conclusion-TheCincinnati criteria identified a large percentage of pediatric cochlear implant patients with EVA who might otherwise have no known etiology for their deafness.