Tinnitus generated by the para-auditory system (vascular and muscular origin) are seldom described in the literature. Although rarer when compared to \"regular\" tinnitus, they may be easily suspected by the anamnesis. The purpose of this study was to evaluate the frequency of tinnitus generated by vascular and muscular structures among a population of tinnitus patients and to analyze their characteristics. From January 1995 to June 1999, 358 tinnitus patients were attended following a medical-audiological protocol. The identification of tinnitus generated by the para-auditory system was performed by the anamnesis: tinnitus referred to as \"pulsations\" synchronous with the heartbeats were considered as vascular ones, while those \"clicks\" not synchronous with the heartbeats were considered as muscular ones. Among the 358 patients enrolled in this study, 72 (20,11%) were identified as having pulsatile or muscular tinnitus. There were 56 females (77,78%) and 16 males (22,22%). The tinnitus was perceived as a single sound in 26 patients and as multiple sounds in 46. It was subjective in 66 cases and objective in only 6 cases. Impairment in sleep, concentration or emotional balance was observed in 19% of the cases. The authors conclude that tinnitus generated by vascular or muscular structures may be more common than expected. Since both of them are medical problems and have specific treatments, the otolaryngologist should be alert to the tinnitus characteristics during anamnesis in order to differentiate these patients from those who have tinnitus generated by the auditory pathways and perform the correct treatment.