Pontine tegmental cap dysplasia (PTCD) is a rare disease associated with hearing loss. We present a case of a child with PTCD and Perventricular nodular heterotopia (PNH). PTCD is a brainstem, cerebellar and cranial nerve malformation syndrome characterized by several clinical manifestations. PNH is a condition in which neurons do not migrate properly in the first stage of brain development. Diagnosis of both pathologies is based on the characteristic neuro-image findings. The child was evaluated, in our department, for congenital profound hearing loss, several signs and symptoms emerged during the diagnostic analysis. The clinical data and Neuro-image tests evidenced a diagnosis of PTCD and PHN. Cochlear Implant (CI) therapy for hearing loss in this case is discussed.I treatment in cases with profound hearing loss in PTCD is useful. These patients need a challenging and complex rehabilitative program. An adequate evaluation of clinical and functional responses and a cost-benefit analysis is necessary in the choice of monolateral or bilateral CI. A multidisciplinary and multicenter consensus could be useful in the therapeutic management of similar cases.