The jugular bulb is the upper part of internal jugular vein in the temporal bone. Occasionally, the jugular bulb may be high. The relationship between a high jugular bulb and various inner ear diseases has been discussed by several authors. A high jugular bulb with jugular bulb diverticulum is an extremely rare condition which is thought to affect inner ear. We describe a patient with a high jugular bulb and a jugular bulb diverticulum and discuss the relationship between this condition and inner ear disorders.A 32-year-old woman had had recurrent vertigo attacks and right tinnitus for 4 years. She did not notice any hearing impairment. She suffered a severe vertigo attack starting September 19, 1991 and was admitted to Otowa Hospital on September 27.Equilibrium function was essentially normal. Pure tone audiogram (on the right) revealed low tone sensori-neural hearing loss. The acoustic brainstem response was almost symmetrical and there was no inter-peak-latency prolongation. A right plain x-ray (Schuller) showed an ordinary sigmoid sinus plate, but CT scan revealed a high jugular bulb on the right. MR angiography demonstrated a high jugular bulb and also a jugular bulb diverticulum.