Purpose: Acute Low-frequency sensorineural Hearing Loss (ALHL) is characterized by earfullness, tinnitus and hearing loss restricted to the low frequency region. The aim of this study was to investigate the characteristics and prognosis of tinnitus in ALHL. Methods: We investigated tinnitus characteristics with analyzing tinnitograms and studied correlation between tinnitus improvement and hearing recovery of ALHL patients. We classified hearing change after the four weeks of medical treatment applying oral steroid and diuretics into ‘complete recovery,’ ‘partial recovery,’ and ‘no change.’ Degree of tinnitus improvement following the treatment was categorized as ‘completely disappeared,’ ‘partially improved,’ and ‘persistent.’ Results: Among 46 ALHL patients, tinnitus was reported by 34 (74.0%) patients. After the medical treatment tinnitus completely disappeared in 19 (55.9%), partially improved in 9 (26.5%), and persisted in 6 (17.6%). Among 26 patients who completed tinnitograms, tinnitus was matched at frequencies ≤ 500 Hz in 14 (53.8%) and at ≥ 2,000 Hz in 12 (46.2%), respectively, forming lower and higher frequency tinnitus groups. Tinnitus completely disappeared or partially improved in 12 (85.7%) patients with lower frequency tinnitus and in 9 (75.0%) with higher frequency tinnitus. We observed a significant positive correlation between hearing recovery and tinnitus improvement in both lower and higher frequency tinnitus groups (r = 0.74 and r = 0.62, respectively). Conclusion: Patients with ALHL may complain the high frequency tinnitus although their hearing loss recently developed in low frequency region. Tinnitus associated with ALHL was successfully treated with applied medications, showing better treatment for lower frequency tinnitus group. Hearing recovery and tinnitus improvement were significantly correlated.