Tip clearance between blade end and shroud is inevitable in pump operation and of great importance on pump energy performance and pressure fluctuation. As the tip clearance size increases, the head and efficiency of the mixed flow pump drop accordingly. The simulation results show that the development of a leakage vortex is observed as the tip clearance increases, and the trajectory of this leakage vortex remains in the same direction along the blade suction side for different tip clearances. With the increase in tip clearance size, the intensity of the leakage vortex is enhanced, and the separation between the main leakage vortex and the secondary leakage vortex is also strengthened. The leakage separation angle near the blade tip remains at the same value of 10° for different tip clearance sizes. As for the spectrum analysis, the maximum amplitudes of pressure fluctuations dramatically increase in the impeller when the tip clearance increases from 0.0 mm to 1.0 mm, and the dominant frequencies go from 145 Hz to 184 Hz due to the considerable leakage flow.