Background Sigmoid sinus wall reconstruction (SSWR) is a proven effective treatment for pulsatile tinnitus (PT) caused by sigmoid sinus wall dehiscence (SSWD) with or without sigmoid sinus diverticulum (SSD); however, comprehensive analysis of the postoperative imaging manifestations has not yet been reported. Purpose To analyze temporal bone computed tomography (CT) imaging features following SSWR in patients with PT. Material and Methods Following SSWR, temporal bone contrast-enhanced high-resolution CT (HRCT) images from 33 PT cases were retrospectively analyzed. Patients were divided into two groups based on follow-up interval: a short-interval group (<= 18 months, 12 cases) and a long-interval group (>18 months, 21 cases). The mending material density and morphology was analyzed. Postoperative changes of the venous sinus were evaluated. Imaging manifestations of the normal temporal bone and mastoid air cells adjacent to the operative field were observed. Results The order of CT values of mending materials was significantly lower in the short-interval group than in the long-interval group (Z = -4.716, P < 0.001); the incidence of complete newly remodeled cortical bone on the rim of the mending materials was significantly higher in the long-interval group than in the short-interval group (P < 0.001). Eleven patients (33.3%) showed varying degrees of remnant SSWD. The mending materials and normal mastoid bone structure showed complete fusion (n = 12, 36.4%), partial fusion (n = 16, 48.5%), or complete separation (n = 5, 15.2%). Conclusion Temporal bone contrast-enhanced HRCT can be used to observe imaging features of the mending materials, venous sinus, adjacent normal temporal bone and mastoid air cells following SSWR.