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A high jugular bulb is often discovered as an incidental finding that is asymptomatic. The incidence of high jugular bulb protru-ding into the level of oval window is rare. Conductive hearing loss in asociation with this anomaly may occur, but has been ch-anisms to explain the conductive hearing loss include contact of the jugular bulb with tympanic membrane, interference with the ossicular chain, and obstruction of the round and oval window niche. The operative findings, radiographic and audiometric data that support these mechanisms of couductive hearing loss are presented. (Korean J Otolaryngol 2002 ;45 :1184-7)