Runner and distributor blockages in hydraulic turbines occur due to the ingestion of external bodies such as rocks or logs. These obstructions can change the amplitude and uniformity of the pressure pulsations in the machine, creating large unbalanced forces that can lead to reduced efficiency, increased vibration and mechanical damage. In this paper, the effects of obstructions caused by ingested bodies in the runner and the distributor of a pump turbine on its internal pressure pulsation were investigated by means of computational fluid dynamics. A numerical model of an unobstructed pump turbine is presented and validated against experimental data. Several cases of runner or distributor blockage were studied, and their RSI pressure pulsations were recorded and analyzed at different locations. The results obtained allow us to characterize the effect of these blockages on the machine’s RSI, which can be helpful for the correct diagnosis of these types of damage.