Sudden tinnitus accompanied by dizziness and blackness in front of the eyes is considered to be caused by insufficient blood supply to the brain after the appearance of the trigger. Ischemia in the internal auditory and ophthalmic arteries can cause tinnitus, deafness, or blackened and blurred vision. However, if tinnitus is accompanied by visual rotation, otogenic vertigo, such as Meniere’s disease, is considered. However, if the tinnitus is accompanied by blackening of the eyes, the consideration remains that vascular ischemia is more likely. In this case, we should look for the causative factors, such as frequent staying up late, exertion, large emotional fluctuations, blood pressure fluctuations, bad habits, smoking and alcohol consumption, all of which can cause insufficient blood supply to the brain and can lead to tinnitus accompanied by dizziness and blackness in front of the eyes. Therefore, it is important to first identify whether it is vascular insufficiency of blood supply or otogenic vertigo, and use the right medicine according to the specific situation.