The objective of this study was to investigate the correlation of tinnitus severity and sleep quality prior to tinnitus onset in a Chinese population.We recruited patients with primary tinnitus from a tertiary teaching hospital in southwest China, retrospectively. The Pittsburgh Sleep Quality Index (PSQI) and the Mandarin version of the Tinnitus Handicap Inventory (THI-M) were employed to assess tinnitus severity and sleep quality of past, respectively. A battery of hearing tests was also administered to subjects, including TEOAE, pure tone audiometry, and tympanometry, for hearing evaluation.We enrolled 190 patients and nine were excluded. Subjects were divided into two groups: group A (PSQI <7) and group B (PSQI >= 7). The mean duration of tinnitus in both groups was above 6 months. There was a significant difference between THI-M global scores of group A and group B (P < 0.001). The difference in tinnitus severity ranks between the two groups was also significant (P = 0.006). The proportion of severe tinnitus levels in group B was higher than that of group A. Spearman's correlation analysis did not show correlation between the scores of THI-M and that of the PSQI in group A (P = 0.077); in verse, a positive correlation between THI-M and PSQI scores was found in group B (P < 0.001).The tinnitus severity is positively correlated with sleep quality before tinnitus onset, suggesting that the sleep quality of the past may have an impact on tinnitus occurrence.