“The sound of a heartbeat in the ear” is mainly considered as pulsatile tinnitus, and it is recommended to clarify the cause of the disease after timely consultation, and then according to the cause of the corresponding treatment, such as surgical treatment, symptomatic treatment and so on. The occurrence of tinnitus is often associated with hemodynamic disorders, including arterial factors, such as cerebral arterial malformations, traumatic cavernous sinus fistula of the internal carotid artery, dural arteriovenous fistula at the base of the skull, atherosclerosis of the cervical or base of the skull arteries, etc., which can result in a murmur consistent with the heartbeat; venous factors, which are commonly found in the cerebral venous sinus anatomical variations. Appropriate surgical treatments are available, including lumbar large pool-abdominal shunt, which reduces intracranial pressure and alleviates hydrocephalus; carotid endarterectomy and carotid endoluminal stenting, which relieves hemodynamic disturbances caused by carotid artery stenosis; tympanic bulbectomy, which removes tumors within the tympanic cavity and relieves tinnitus; and sigmoid sinus diverticulosis repair, which improves anatomical variations. For those whose etiology is unclear, there are also options for psychotherapy, as a way to relieve anxiety and depression caused by tinnitus; and sound therapy, which involves white noise, specific music, etc. to mask the sound of tinnitus, thereby relieving symptoms. Pulsatile tinnitus is a rarer form of tinnitus that, in addition to hemodynamic disorders, may be associated with tumors, cerebrospinal fluid abnormalities, and so on. It has a complex etiology, a wide range of involvement, and a slow onset and prolonged course without critical complications. It is recommended that people with pulsatile tinnitus, which seriously affects their lives, seek prompt medical attention.