In recent years, variable speed pumped-storage (VSPS) technology has become a hotspot of research and application due to its excellent power grid regulation capabilities. Since the speed of a VSPS unit is changeable, when switching operating conditions, more stable operating trajectories can be chosen to reduce vibration and damage. The simulations of transient processes of VSPS units normally use 1D method, which cannot judge the quality of operating conditions because of no flow pattern and pressure pulsation information. Using 3D CFD simulation based on OpenFOAM, we analyse the flow patterns and pressure pulsations when a VSPS unit with a full size frequency converter (FSFC) is in the turbine start-up process. The typical operating points in the variable speed transient trajectories obtained from 1D simulation are studied. It is found that in the initial stage of start-up, high-speed circulation flow arises in the vaneless space, leading to flow separation and large pressure pulsation. The results can provide a reference for the operation of VSPS power stations, so as to avoid operating conditions with adverse flow patterns and pressure pulsations.