The role of precipitation processes in defect development in high temperature implanted single and multiple implant/anneal SIMOX was studied by transmission electron microscopy. The differences in defect type, density and location were compared. The dominant defects in single implanted and annealed material are pairs of narrow stacking faults (NSFs) at a density of approx. 106 cm-2 while stacking fault pyramids (SFPs) at a similar density dominate multiple implant/anneal material. However, SFPs are confined to the buried oxide interface and thus the density of through-thickness defects is about two orders of magnitude lower in multiple implant (<104 cm-2) than in single implant material (approx. 106 cm-2). SFPs are formed from a collection of four NSFs pinned to residual oxide precipitates. This transformation is energetically possible only below a critical NSF length which is dictated by the relative location of the residual precipitates. In turn, the residual precipitate location is determined by the location of as-implanted defects on which SiO2 preferentially nucleates and grows. Thus, the synergistic interaction between precipitation and defect formation and evolution processes plays a key role in determining the final defect microstructure of SIMOX.