Background: Cochlear implants (Cis) can improve speech recognition for children with severe congenital hearing loss, and open-set word recognition is an important efficacy measure. This study examined Mandarin open-set word recognition development among Chinese children with Cls and normal hearing (NH). Methods: This study included 457 children with CIs and 131 children with NH. who completed the Mandarin lexical neighborhood test. The results for children at 1-8 years after receiving their Cls were compared to those from the children with NH using linear regression analysis and analysis of variance. Results: Recognition of disyllabic easy words, disyllabic hard words, monosyllabic easy words, and monosyllabic hard words increased with time after Cl implantation. Scores for cases with implantation before 3 years old were significantly better than those for implantation after 3 years old. There were significant differences in open-set word recognition between the Cl and NH groups. For implantation before 2 years, there was no significant difference in recognition at the ages of 6-7 years, compared to 3-year-old children with NH, or at the age of 10 years, compared to 6-year-old children with NH. For implantation before 3 years. there was no significant difference in recognition at the ages of 8-9 years, compared to 3-year-old children with NH, or at the age of 10 years, compared to 6-year-old children with NH. For implantation after 3 years, there was a significant difference in recognition at the age of 13 years. compared to 3-year-old children with Conclusions: Mandarin open-set word recognition increased with time attcr Cl implantation, and the age at implantation had a significant effect on long-term speech recognition. Chinese children with Cls had delayed hut similar development of recognition, compared to normal children. Early CI implantation can shorten the gap between children with Cis and normal children.