Objective To observe the surgical effect of sigmoid sinus repayment and sinus wall reconstruction on vascular pulsatile tinnitus caused by sigmoid sinus diverticulum and bone wall defect.?Methods The clinical data of 7 patients with vascular pulsating tinnitus admitted to the Department of Otolaryngology Head and Neck Surgery of the Second Weihai Municipal Hospital from January 2019 to September 2021 were analyzed retrospectively. The changes of tinnitus on the day, one month,six months and one year after operation were observed.?Results All patients were female, 6 patients were on the right side and 1 patient on the left side.?After clinical manifestations, thin slice CT of temporal bone, brain MRA and MRV examination, it was confirmed that there was pulsatile tinnitus of sigmoid sinus origin. The score of the Tinnitus Disability Inventory (THI) was above Grade III. All patients were operated under general anesthesia, of which 6 patients with sigmoid sinus diverticulum accompanied by sigmoid sinus bone defect received sigmoid sinus diverticulum repayment and sinus wall reconstruction, and 1 patient with transverse sinus diverticulum received sigmoid sinus and transverse sinus repayment and sinus wall reconstruction.?Five cases were cured ,1case was markedly effective and 1 case was effective after 1 year of follow-up.?Conclusion The effect of sigmoid sinus plasty for pulsatile tinnitus caused by sigmoid sinus diverticulum or bone wall defect is accurate and worthy of clinical reference.