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To assess incidence and changes in tinnitus and bothersome tinnitus as well as associated risk factors in a large sample of UK adults. Prospective cohort study. UK. For cross-sectional analysis, a group of 168 348 participants aged between 40 and 69 years with hearing and tinnitus data from the UK Biobank resource. Longitudinal analysis included a subset of 4746 people who attended a 4-year retest assessment. Presence and bothersomeness of tinnitus. 17.7% and 5.8% of participants reported tinnitus or bothersome tinnitus, respectively.