Summary Hearing, Speech, & Language Center, Sheba Medical Center, Ramat Gan; Dept. of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Accumulating evidence suggests that single-sided deafness (SSD) during early development results in cortical reorganization. Children with SSD (CHwSSD) are deprived of binaural hearing and consequently exhibit reduced audibility, compromised sound localization, and difficulties in listening in noise. Despite these detrimental effects, information regarding auditory function and processing efficacy is scarce, and clinical assessment tools are underdeveloped for this unique population. The current study was set to evaluate audibility and cortical speech processing, and to provide insight into binaural processing in CHwSSD using a cochlear implant (CI). The P1 potential to acoustically-presented speech stimuli (/m/, /g/, /t/) was recorded during monaural [Normal hearing (NH), CI] and bilateral (BIL, NH+CI) listening conditions within a clinical setting in 22 CHwSSD (mean age at CI/testing 4.7, 5.7 years). Robust P1 potentials were elicited in all children in the NH and BIL conditions. In the CI condition: 1) P1 prevalence was reduced yet was elicited in all but one child to at least one stimulus; 2) P1 latency was prolonged and amplitude was reduced, consequently leading to absence of binaural processing manifestations; 3) P1 prevalence for /m/ was reduced and associated with CI manufacturer and duration of CI use. Results indicate that recording CAEPs to speech stimuli in clinical settings is feasible and valuable for the management of CHwSSD using a CI. While CAEPs provided evidence for effective audibility, substantial mismatch in cortical processing timing and synchrony between the CI and NH ear remain a barrier for the development of binaural interaction components.