Background: Tinnitus is perception of sound in the absence of an external auditory stimulus. It is an experience that originates from a cause or trigger in the cochlea, brainstem or at higher centres. Methods: A randomized, double-blinded pilot study was conducted, wherein a total of 64 patients were enrolled. Of which 32 were considered as Group A (oral methylcobalamin was administered) and 32 in Group B (intranasal methylcobalamin was administered). Group A patients enrolled randomly received oral methylcobalamin therapy (tablet methylcobalamin 500 mcg tablet once a day for a period of 6 weeks). Group B patients enrolled randomly received intranasal methylcobalamin treatment (nasal spray 500 mcg per day) for a period of 6 weeks. Results: A sum of 19 patients of the total patients included in the study were found to be Vitamin B12 deficient that is 42.1% were considered to be Vitamin B12 deficient when the normal levels were considered to be 250 pg/ml, which could be considered to be a significantly high prevalence. Patients having Vitamin B12 deficiency showed improvement in visual analogue scale score after vitamin B12 therapy. Conclusions: Supplementation of Vitamin B12 in vitamin B12 deficient patients having tinnitus has shown symptomatic improvement. However, no significant improvement in visual analogue scale scores in patients without B12 deficiency was observed. There was improvement in VAS in cobalamin-deficient patients receiving Vitamin B12 weekly for 6 weeks.