목적: Recently, several radiologic abnormalities in a patient’s temporal bone CT have been noticed as the cause of pulsatile tinnitus, and some of the radiologic problems could be treated by a surgical method such as transmastoid reshaping of the sigmoid sinus. Therefore, in clinical field, we are now confronting a decision of surgical management for the pulsatile tinnitus. In this study, the association between the tinnitus and its radiologic findings was investigated, and we suggest some considerations for the treatment. 방법:Data of 43 patients who were suffered from pulsatile tinnitus were enrolled. All the subjects performed temporal bone CT with or without contrast. Basic demographics and the results of pure tone audiogram of the subjects were compiled together. Twelve non-pulsatile patients without hearing problem were sampled as a control group. 결과:Of the 43 subjects, radiologic abnormalities were exhibited in 26 (60.5%). Sigmoid sinus dehiscence was the most common (25.6%). Twenty-four were identified the abnormalities in the ipsilateral side of tinnitus but 2 in the counterlateral side. Increased threshold in 250 Hz in subjects with abnormal findings was noteworthy. Furthermore, hearing threshold in 2,000 Hz was high in patients showing high jugular bulb, and 4,000 Hz was likely to be related with sigmoid sinus diverticulum. 결론:The association between the radiologic abnormalities and pulsatile tinnitus was relatively distinct and considerable. Therefore, radiologic evaluation may be recommended for pulsatile tinnitus, especially in a patient presenting worse hearing in lower frequency.