Subjective and objective pulsatile tinnitus may have many causes. Objective pulsatile tinnitus may be present in paraganglioma, dural arteriovenous malformations or venous anomalies. We report the case of a 23-year-old man with right-sided objective pulsatile tinnitus. MRI and DSA demonstrated thrombosis of the dominant left transverse and sigmoid sinuses. On the tinnitus side, angiography revealed a tight stenosis of the sigmoid sinus close to the petrous bone. Tinnitus improved after anticoagulation and disappeared completely after 9 months. Follow-up angiography 8 months later revealed recanalization of the affected sinuses and persistence of the narrow segment of the right sigmoid sinus.