<p class="abstract"><strong>Background:</strong> Cochlear synaptic tinnitus (CST), also referred to as sensorineural type III tinnitus, is a type of transformation tinnitus, resulting due to aberrant signal transduction between Inner hair cells and afferent nerve fibres owing to excessive and pathologic glutamate release and subsequent spontaneous receptor depolarization (NMDA and AMPA receptors). Of the various pharmacologic agents used for treatment for CST, <em>Gingko biloba</em> and Caroverine have stood the test of time.</p><p class="abstract"><strong>Methods:</strong> A total 48 selected patients of CST, otherwise free from any medical or surgical co-morbidity, were included in the study and divided randomly in two groups, one group receiving oral formulation of Caroverine and the other group receiving oral <em>Gingko biloba</em> in appropriate doses. Both the groups were followed up for 12 weeks. Treatment outcomes were measured in terms of improvement in subjective symptoms (tinnitus grading) and psycho-acoustic measure (tinnitus matching).</p><p class="abstract"><strong>Results:</strong> Although oral caroverine yielded promising results in the initial month of treatment in terms of improved tinnitus matching, long term effect was found to be dissatisfying. Oral <em>Gingko biloba</em>, at the completion of 12 weeks of therapy was found to be more effective in terms of improvement of mean tinnitus grading and matching (p&lt;0.05). Side effects of the test drugs were not noted in either group.</p><p class="abstract"><strong>Conclusions:</strong> <em>Gingko biloba</em> is thus found to be more effective treatment modality for CST for long term basis and is also readily available in the market, cost effective and free of side effects as well.</p>