Objective: The purpose of this study was to determine the relationship between hormone replacement therapy and tinnitus in South Korea using data from the Korea National Health and Nutrition Examination Surveys (KNHANES) (2010 ~ 2012). Study Design : Cross-sectional analysis of a nationwide health survey. Methods: KNHANES is a nationally representative cross-sectional survey of South Korea population. Only postmenopausal women aged 19-65 years were included in the study (n = 2736). Auditory function was evaluated using pure-tone audiometric testing according to established KNHANES protocols. Subjects were questioned about their experience with tinnitus. Exogenous hormone-related factors included the starting age and duration of hormone replacement therapy Results: The overall prevalence of tinnitus was 22.2% among postmenopausal women. 1) Tinnitus severity was significantly higher in women using hormone replacement therapy (p = 0.0024) and 2) significantly lower in women who breast-fed their children (p = 0.0386). 3) According to logistic regression models, the longer duration of hormone replacement therapy was significantly associated with increasing tinnitus (OR = 1.323, 95% CI = 1.007-1.737, p = 0.0441). Conclusion: A longer duration of hormone replacement therapy was associated with developing tinnitus in Korean postmenopausal women. Further experimental and epidemiological researches are needed to elucidate the causal relationship between hormone replacement therapy and tinnitus.