There is a great demand for robust measurements of tinnitus. Although such testing is performed routinely, response reliability has not been demonstrated. The diagnostic approach to tinnitus presents some general problems that must be considered. First of all the different professional consistency between managing other hearing difficulties and assessing tinnitus. Moreover the training programs do not focus on tinnitus management with the consequence of lack of adequate professional standards. A real problem is then to develope clinical management procedures for tinnitus that can be used in a standardized fashion: the multi-dimensional character of tinnitus create many difficulties in its management and objective measurements are hard to find. Finally the frequent association of hyperacusis in tinnitus patients (the prevalence is about 40%) must be take in account early because conditions testing order and treatment. This paper will explain our approach to tinnitus patient assessment that include three main point: aetiological diagnosis, psychometric and psychoacoustic evaluation. The evaluation of tinnitus patients includes three inseparable aspect: the attempt of an aetiological diagnosis, the psychometric evaluation by questionnaires or interviews and the psychoacoustic assessment that is the most problematic point given the lack of objective tinnitus measurements. Finally, a special section will be dedicated to decreased sound tolerance as important aspect able to condition testing ongoing and treatment settings.