The study investigated the phonological awareness abilities of Cantonese-speaking pre-schoolers with cochlear implants. Participants were 15 Cantonese-speaking children with cochlear implants (CIs) aged 3.08-6.10, chronological-age-matched with 15 children with normal hearing. Each participant performed 10 tasks evaluating different levels of phonological awareness abilities and phonological knowledge. The results showed that pre-schoolers with cochlear implants and their normal hearing peers had similar levels of syllable awareness, phoneme awareness and rhyme awareness. However, cochlear implant users showed significantly poorer performance on tone awareness and phonological knowledge tasks than their normal hearing peers. Cantonese-speaking pre-schoolers with cochlear implants were able to develop phonological awareness. However, the cochlear implants might not provide enough tonal information for children with hearing impairment for tonal lexical comprehension. Incomplete speech and language stimulation may affect phonological knowledge development in Cantonese-speaking pre-schoolers with cochlear implants.[Copyright of Informa Healthcare. Full article may be available at the publisher's website: http://dx.doi.org/10.3109/17549507.2011.604428]