Cervical radiofrequency ablation (RFA) is a widely used intervention for chronic neck pain, with utilization rising significantly in recent years. Cervical spondylosis, a leading cause of facet-mediated neck pain, affects up to 85% of individuals over age 60. Simultaneously, over 1 million people worldwide have received cochlear implants (CIs), including an increasing number of aging adults. Performing an RFA in CI patients presents a unique risk: the RF current may induce unintended electrical conduction through the implant’s internal electrode array, potentially leading to overheating, device failure, or permanent cochlear injury. Can a patient with CI receive an ablation to treat their neck pain without interfering with the device? CI manufacturers, including Advanced Bionics, explicitly contraindicate monopolar electrosurgery above the clavicles. Despite the rising overlap between CI recipients and pain patients, no published cases have described how to safely approach cervical RFA in this population. This report outlines the first known case of cervical facet RFA planning in a CI recipient and highlights the perioperative considerations required.