From a radiologic workup perspective, tinnitus is classified into pulsatile, which can be objective, and nonpulsatile, which is typically subjective. There is considerable discrepancy within the literature regarding the percentage of positive findings in patients with pulsatile tinnitus. The authors discuss the overlap in the radiographic findings detected in association with tinnitus in both asymptomatic patients and symptomatic patients and the importance for imaging to detect treatable causes. They discuss imaging related to diagnosis and treatment and provide an imaging workup algorithm.