To explore the influence of tip clearance on pressure fluctuation in a low specific speed mixed-flow pump, tip clearances δ of 0.25 mm, 0.75 mm and 1.00 mm, along with no tip clearance, were selected. The reliability of the simulation was verified by comparison with the experimental data of external characteristics and fluctuation in the guide vane passage. Through ANSYS-CFX, MATLAB code and fast Fourier transform (FFT) algorithm, pressure fluctuation characteristics in this pump were obtained. The results show that pressure fluctuation exists in all conditions due to the rotor-stator interaction. Under the no tip clearance and tip clearance conditions, the maximum fluctuation value was located near the guide inlet and impeller outlet, respectively. Clearance leakage had less influence on pressure fluctuation at the impeller inlet and central regions within a certain range of the clearance; beyond this range, fluctuations in the whole flow passage increased significantly, while the clearance variation had less effect on fluctuation in the guide vane. When the tip clearance value was 1.00 mm, pressure fluctuation of the shroud at the impeller inlet section suddenly increases, which was closely related to the obvious leakage vortexes and a larger low pressure area.