For almost 10 years, chronic stimulation has been known to affect spiral ganglion cell (SGC) survival in the deaf ear. However, the reported effects of chronic stimulation vary across preparations and studies. In this review, the effects of chronic stimulation on the deafened auditory periphery are examined, and variables that may impact on the efficacy of chronic stimulation are identified. The effects of deafening on the unstimulated peripheral and central auditory system are also described, as the deafened, unstimulated system is the canvas upon which stimulation-mediated effects are imposed. Discrepancies in the effects of chronic stimulation across studies may be attributable in large part to the combined effects of the deafening method and the post-deafening delay prior to chronic stimulation, which vary across studies. Emphasis is placed on the need to consider the natural progression of SGC loss following deafening in the absence of chronic stimulation, as the rate of SGC loss almost certainly affects both the efficacy of stimulation, and the impact of any delay between deafening and initiation of stimulation. The differences across preparations complicate direct comparison of protective efficacy of stimulation. At the same time, these differences can be used to our advantage, aiding characterization of the effects of different factors on the efficacy of chronic stimulation as a neuroprotective intervention.