In this study, a method for determining the optimal location and orientation of an implantable piezoelectric accelerometer on the short process of the incus is presented. The accelerometer is intended to be used as a replacement for an external microphone to enable totally implantable auditory prostheses. The optimal orientation of the sensor and the best attachment point are determined based on two criteria—maximum pressure sensitivity sum and minimum loudness level sum. The best location is determined to be near the incudomalleolar joint. We find that the angular orientation of the sensor is critical and provide guidelines on that orientation. The method described in this paper can be used to further optimize the design and performance of the accelerometer.