ObjectiveTo discuss the various symptoms and causes of objective tinnitus in children.Study DesignRetrospective case review.PatientsFive children who had audible signals emanating from their ears caused by audible spontaneous otoacoustic emissions, palatal myoclonus, arteriovenous malformation, and acoustic trauma.Main Outcome MeasureThe tinnitus reported by the patients was linked to acoustic signals that could be measured objectively or heard by the examiner.ResultsFour of the five children had essentially normal hearing. The one child who demonstrated a hearing loss audiometrically was thought to have normal hearing sensitivity, but his intense roaring objective tinnitus appeared to mask his low-frequency thresholds. All five patients had measurable acoustic signals in the ear canal that matched the patients' descriptions of their tinnitus.ConclusionThe cases illustrate how the objective tinnitus was diagnosed and measured, how a treatment algorithm was applied, and the expected results of treatment. In addition, the cases provide support for the use of psychologic counseling throughout the examination and treatment of objective tinnitus in children.