Sigmoid sinus diverticulum-induced pulsatile tinnitus is a rare medical problem. Here we report a case where pulsatile tinnitus occurred in the perimenopause with evidence of sigmoid sinus diverticulum. The tinnitus disappeared with the restoration of hearing after surgery. While diagnosis is critical for the treatment, this disorder can be diagnosed relatively easily, and a satisfactory therapeutic outcome can be achieved using a simple surgical approach. The sigmoid sinus diverticulum may be a clinical manifestation of osteoporosis occurring in the perimenopausal period.