<p>Tinnitus, the perception of sound in the absence of external acoustic stimuli, involves auditory, attentional, and limbic systems also implicated in pain, stress, and anxiety. This early-stage study assessed usability, acceptability and usefulness of a virtual reality (VR) system in tinnitus management, participant preferences for virtual environments (VEs), and is the first to explore short-term effects of spatialised VR audio-visual masking on tinnitus severity. 17 participants with chronic tinnitus undertook a VR tutorial followed by immersion in 3 VEs (blank, beach, and forest environments). In each environment, participants completed tinnitus severity scales before, during, and after spatialised masking noise activation, emanating from a virtual radio that could be fixed in relation to the head. Usability and tinnitus severity measures were recorded in each environment and after completing all VEs. Tinnitus severity decreased significantly during masking noise activation for all VEs. Benefit appeared to accumulate, with each subsequent VE producing further decreases in severity. Participants found the technology easy to use, relaxing, useful, novel, and enjoyable. A System Usability Scale score of 72.3 indicated good usability. Participants reported that the ability to move and fix the position of the virtual radio in relation to the head was useful for tinnitus management. Usability and acceptability of our VR system was high and all participants believed it may be useful in tinnitus management. Only short-term benefits were examined, but results from this initial study demonstrate that further development and research into long-term benefits of the system are worth exploring.</p>