Carotid-cavernous fistula is a rare disorder occurring spontaneously or due to head trauma, predominent in men. The characteristic symptoms are pulsating tinnitus, orbital and cranial bruits, orbital pulsating protrusion, conjunctival edema, diplopia, deep seated headache, and exophthalmos. Orbital pseudotumor, posterior orbital tumor, carvernous sinus thrombosis, and orbital hemangioma must be excluded. Treatment methods are fistula embolization using muscle piece, polyethylene, acrylic, gelfoam, porcelain, polyurethan foam by using balloon catheter, and direct intracranial surgery. Recently the authors experienced a case of carotid-cavernous fistula causing severe pulsating tinnitus which occurred two months after facial bone fracture and comfirmed by carotid angiography, and obtained satisfactory results with improvement of tinnitus by occluding a fistula with detachable balloon catheter and silicone. We report this case with review of literatures.