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To determine the safety, efficacy, and potential for hearing preservation of an electroacoustic hearing system in patients with severe high-frequency and moderate low-frequency hearing loss.Five patients were included in this study with steeply down-sloping sensorineural hearing loss. All patients had a history of hearing aid use and similar hearing in the contralateral ear. Ages ranged from 48 to 69 years.All participants were implanted with an electro-acoustic stimulation (EAS) device using a hearing preservation technique. This device integrates electric and acoustic stimulation into a single processor for simultaneous ipsilateral bimodal stimulation.Pure-tone audiograms (PTA) and speech reception thresholds (SRTs) during preoperative evaluation; initial cochlear implant (CI) stimulation; initial EAS stimulation; and at 3, 6, and 12 months poststimulation. Consonant-Nucleus-Consonant (CNC) monosyllables preoperatively and at 3, 6, and 12 months poststimulation.All participants showed preserved hearing in the surgical ear after implantation as measured by PTA and SRT. Significant improvement in speech recognition testing over hearing aid was observed at 3 months with EAS versus 6 months with CI-only stimulation. Facial stimulation occurred in 1 patient and resolved after reprogramming.There were no significant complications in this cohort of patients. Adequate hearing preservation was achieved. EAS and CI aided conditions both showed significant improvement over hearing aid with EAS condition achieving significance sooner.