Ringing in one ear (left or right): causes and when to see a doctor

Ringing in one ear often has a simple cause, such as earwax, an ear infection or loud noise, and a serious cause is rare. Guidelines still advise having tinnitus in one ear checked, usually with a look in the ear and a hearing test, and sometimes a scan. Whether it is the left or the right ear makes no difference.

Last reviewed: 28 October 2026

By the Tinnitus Haven editorial team. Sources are listed at the end of the page.

Causes and symptoms

This guide is general information, not medical advice. If your tinnitus is new, one-sided, pulsing or comes with hearing loss or dizziness, see a doctor.

Is ringing in one ear serious?

Usually not. Tinnitus is only rarely linked to a serious medical problem^[1], and several common causes of ringing in one ear, such as earwax or an ear infection, can be treated^{[1, 2]}. Doctors still take one-sided tinnitus seriously. NICE advises considering a referral for persistent tinnitus in one ear, and a referral when tinnitus comes with hearing loss in one ear or hearing that is worse on one side^[3]. The US guideline recommends a prompt, full hearing test when tinnitus is in one ear^[4].

Does it matter whether it is the left or the right ear?

No. The guidelines we rely on make no distinction between left and right: what counts is that the tinnitus is on one side only^{[3, 4]}. The same possible causes and the same checks apply to either ear.

What are the common causes?

Earwax. A build-up of earwax can cause ringing or buzzing, hearing loss and a blocked feeling^[5]. Do not use your fingers or cotton buds to remove it, because this pushes it further in. A few drops of olive or almond oil, or advice from a pharmacist, can help it come out^[5].
An ear infection. Fluid from an ear infection can block the ear canal and trigger tinnitus^[1]. Most ear infections clear up within three days^[6].
Loud noise. Noise can cause hearing loss and tinnitus in one ear or both, and a single very loud bang, such as a gunshot or an explosion, can damage hearing at once^[7]. After loud noise, dulled hearing often recovers within 16 to 48 hours, although some lasting damage is possible^[7].
Hearing loss in that ear. Tinnitus is strongly linked to hearing loss^[1], and NICE treats tinnitus with hearing loss in one ear as a reason for referral^[3].
Jaw joint problems. The jaw joint sits close to the ear, and clenching or grinding the teeth can cause or worsen tinnitus^[1].

What are the less common causes?

Ménière's disease, an inner ear condition with attacks of vertigo, tinnitus, hearing loss and a feeling of fullness in the ear. It usually affects one ear^[8].
Sudden hearing loss, which often affects only one ear and can come with tinnitus, a feeling of fullness or dizziness. It should be treated as an emergency, because treatment works best when it starts early^[9].
Acoustic neuroma (vestibular schwannoma), a non-cancerous growth on the nerve for hearing and balance. It usually grows slowly, and symptoms tend to come on gradually: hearing loss that usually affects one ear, tinnitus and unsteadiness. Small ones often only need to be watched with regular scans^[10].
Pulsing tinnitus that beats in time with your heart has its own causes and needs a doctor's check; see our guide to pulsatile tinnitus.

An acoustic neuroma is what many people worry about, but it is rarely the cause. A 2023 review pooled seven studies of 1,394 people who had an MRI scan because of tinnitus in one ear without uneven hearing loss: 7 of them had an acoustic neuroma, most of these were small, and most were monitored rather than removed^[11].

What will the doctor check?

Your ears, for earwax, infection or a problem with the eardrum^{[2, 1]}.
Your history: when the ringing started, your hearing, noise exposure, dizziness and your medicines^{[1, 4]}.
A hearing test. The US guideline calls for a prompt, full hearing assessment when tinnitus is in one ear^[4], and NICE recommends a hearing assessment for everyone with tinnitus^[3].
Sometimes an MRI scan. NICE recommends one when tinnitus comes with other ear, hearing or neurological symptoms, and says it can be considered for one-sided tinnitus even without other symptoms^[3]. The US guideline advises against scans for tinnitus that is not on one side, does not pulse and has no other warning signs^[4].

Being sent for a scan is a routine precaution. It does not mean the doctor expects bad news.

When should I get help quickly?

Get help straight away (emergency department or emergency number) if:

the ringing started after a head injury^[2]
it comes with sudden hearing loss, weakness in your face or a spinning feeling (vertigo)^[2]
you have other sudden neurological symptoms^[3]

Be seen within 24 hours if:

the hearing in that ear dropped suddenly, over three days or less^[3]

See a doctor soon if:

the ringing in one ear does not go away^{[3, 4]}
the hearing in that ear seems worse than in the other, or is getting worse over days or weeks^[3]
it beats in time with your pulse; ask for an urgent appointment^[2]
your ear still feels blocked after five days of earwax treatment^[5]

What can I do in the meantime?

Leave the ear canal alone: no cotton buds or other objects^[5].
Protect your ears from loud noise, which can make tinnitus worse^[3].
Avoid total silence. Soft background sound may make the ringing less noticeable^[2]; see our sound therapy guide.
If the ringing bothers you, our guides on tinnitus flare-ups and stress and anxiety have practical steps.

Tinnitus Haven brings sound therapy, a hearing check and CBT-based lessons together in one calm iPhone app, coming soon to the App Store. Learn more about Tinnitus Haven.

Sources

National Institute on Deafness and Other Communication Disorders (NIDCD), NIH. Tinnitus. 2023.
NHS. Tinnitus. NHS website, 2024.
National Institute for Health and Care Excellence (NICE). Tinnitus: assessment and management (NG155), Recommendations. NICE guideline, 2020.
Tunkel DE, Bauer CA, Sun GH, et al. Clinical practice guideline: tinnitus. Otolaryngology, Head and Neck Surgery, 2014 (AAO-HNSF).
NHS. Earwax build-up. NHS website.
NHS. Ear infections. NHS website.
National Institute on Deafness and Other Communication Disorders (NIDCD), NIH. Noise-induced hearing loss.
National Institute on Deafness and Other Communication Disorders (NIDCD), NIH. Ménière's disease.
National Institute on Deafness and Other Communication Disorders (NIDCD), NIH. Sudden deafness.
NHS. Acoustic neuroma (vestibular schwannoma). NHS website.
Javed A, Okoh M, Mughal Z, Javed F, Gupta K. Incidence of vestibular schwannoma in patients with unilateral tinnitus: a systematic review and meta-analysis. Otology and Neurotology, 2023.