Pulsatile tinnitus (PT) is usually an initial symptom of dural arteriovenous fistula (dAVF), although commonly neglected or overlooked if not suspected on initial diagnostic work–up. Here we are presenting a case of pulsatile tinnitus of over a decade duration without any neurological impairment and its complete resolution after embolization with almost complete resolution of tinnitus. Hence, not only otolaryngologists but also neurologists and neurosurgeons should be aware of this entity and meticulously evaluate patients with PT. In almost all cases PT originating from dAVF can be cured with trans–arterial embolization irrespective of its location and its venous drainage pattern.